1971, 04-12 Permit App: I4004 Residence, Renewal of I421 i
County of Spokane. Washington
vii
BUILDING CODES DEPARTMENT. COURTHOUSE. SPOKANE, WASHINGTON 99201 P1'
APPLICATION FOR LAND USE OR STRUCTURE PERMIT �-�
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or st cture of any
kind or alter any building or structure already erected, or to change a land use. Construction must conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. Water supply must be approved by the County and State Health Departments. Where work on water connections disturbs
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.235.
SET-BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set-back from the front property line, of at
least 25' is required, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yard are required.
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set-back and ingress
and egress.
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
performed in accordance with stakes. Points of ingress and egress must be approved by the County Engineer.
MOVING OF BUILDINGS. A permit is required to move an existing building. When a building is moved on a County or State
Highway, clearance must be obtained from the County Engineer and/or State Highway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit.
RESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running with the land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE qCt o fName of Owner 6 4 f iL,f ddress !�!_ _ / ,.. _._ Phone ) et Y— 72- 7
Architect Phone Engineer / Phone
Contract. *go' .- _J-, Address Phone
Leg.4 Description of Property (Give complete descr'• '•n/ rom deed, tax receipt /•c.) 02 S' c.7 (( / S� , V.
is . ... - �� �G�_ �]
1 / "•'mow i 1 6 Tr4
DESCRIPTION OF WORK:Ne Addition Remodel Moving Bldg.Zone / Fire Zone
Size of Lot / 0 d X I Z .1 // ,/ 2 a V. Sewage System c Stories f
Const. (Dimensions A. 2-4 ,L Z`� ` Total Sq. Ft. le-C 17 Valuation
(Frame,concrete,brick,etc.)
Rooms 5- Baths Baseme Foundation Const.(?1(_t 4.. Z Chimney Fireplace
-‘(Full, par none) (Kind) (Number)
Heat. System 4..s Type of Roofing -� UV� Ext. Finish Int. Wall Finish
Use of Bldg. gliCt-j7ThNo. of Units Bedrooms
Garage or Carport Attached Private Detatched
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
.. ••osed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem :nd water supply lines.
Aiiie NORTH State License No.
Villa Ind. Ins. Acct. No.
67-.-"...e.A.7-6--1 `r c>,---4 712---(
REQUIRED
)::3:7-3.1 Plumbing Permit Ara
m Heating Permit �MI/A
to � Sewage Permit OF
-I .4
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I her•. ertify 'n ormati. s ....'te. is correct and there are no other structures located on this property except
shown.
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be J,-.30 d 7 ! •�_e_1,L-C..k.y -dc The zone is
Sewage Permit Number Issued Building Permit p Receipt 3H.y 9 Issued
70 4i,
Remarks
Form 523 Bldg. Code