1971, 09-27 Permit App: J0815 Addition ,
County of Spokane, Washin ton
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, 1., SHINGTON 99201 ii °
APPLICATION FOR LAND USE OR STRUCTURE PERMIT A.
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution tc erect a building or structure 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 insio-tion.
WATER. Water supply must be approved by the County and State Health Departments. Whtre 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 No . 45-133 and 47.235.
SET-HACK 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 IH BELOW THIS LIME 54 ,, , _ g9 &
Name of Owner � ��
___Address 6_2 til . 1 i �� Phone
Architect_ P one Engineer,
Contractor — ------------ -- ___---__ Phone
Address _ _ _ Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
- -4ors -8ic9 l3 'r Z/ TAY46R.S -
iQ.Esu�V��--QF__M1���L3�-_PSK A-47E)
DESCRIPTION OF WORK:New Addition le' Remodel
Size of L 6 O
f 7 ____Moving Bid .Zone Fire Zone
/
Coast. k , C.Q,, Dimensions
'7 x 6x�, Sewage System Stories
(Frame,concrete,brick,etc.) —"notal Sq. Ft. 7a Valuation .10DO
Rooms / Baths Basement I Foundation Coast.
(Full, part, none) — ------ Chimney Fireplace
Heat. System T :4,,;(.1, (Kind) (Nu r)
ype of Roofing Ext. Finish
- [� Int. Wall Finish
Use of Bldg.
---------__________ —No. of Units Bedrooms
Garage or Carport Attached �'. — —
Priv,ae Dot:It<h:al
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NOAYH� + State License No.
A
,
>2� s1 Ind. Ins. Acct. No.
1 D o 1p
^ � _ I REQUIRED
Plumbing Permit
I Pm Heating Permit
A
—�c '
to Sewage Permit -
i
2
IIPlans Received
"r` s Plans Checked
N
Plans Returned
-----. .;
Plans Picked Up
t) Plans
Plans Mailed
SOUTH
I hereby certi information submitte is correct and there are no other structures located on this property except
as shown- / - a
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES REF ;_+ 1,, Date
THIS IS NOT A PERMIT. CONSTRUCTION COMMENCES.
DO NOT WRITE Oft-.„iW 7,..;,;:!'Al
Your street address will be .1��'
Sewage Permit Number Issued ___--- ^.`t' .
Remarks — { r (,; Issued
Form 523 Bid g. :ode . _- -_._ __
i