1971, 02-11 Permit App: J1744 MH County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE ! I
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of MY
kind or alter any building or structure already erected, or to change a land use. Construction must conformmwwith the
Spokane Cpwnty Building Code and Zoning Ordinance. Construction is subject to inspection.
IIAT e2E�. Rater 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.
y� APPLICANTLI�- FILL IN BELOW/ THIS LINE �/ _
Name of Owner ! J C4n2-C-fit �, Address d= s- '6 �- Phone4'2' / --5 7 3
Architect_ ,rPhone Engineer Phone
Contractor ,-e -n---1:.__ Address Phone
Legal Description of Property (Give complete descr'ption from deed, tax receipt, etc.) ,;"2.4-(2--- 5 Y y _ �'
a -
DESCRIPTION OF WORK:New Addition Remodel Moving Bldg.Zone / Fire Zone
Size of Lot Es''C) X / 3s•---
c.(21,,..§1,,,,
Sewage Systeme - Stories
Co Dimensions X6 Total Sq. Ft. Valuatio
Stories
C-
( amen concrete,brick,etc.) -------
(:,C2,
-_.__
ms 4/ Baths Basement Ao-
Foundation Const. -yy-- --.-✓- ' Chimney Fireplace
r �/�/-' (Full, part, none) R7-0--e-
� (Kind) umber)
Heat. System-,"� E-`-- Type of Roofing �� Ext. Finish ,2 *'''''.•0---1(----Int. Wall Finish } ".'�--'
Use of Bldg. _ .c.-v..4?.. c -g— 4:Z No. 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
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines. State Li se No.
NORTH
.., ,✓‘ 1 -.�-.___.. !G' tom!/ Ind. Ins. Acct. No.
,., /`� >.
ti
REQUIRED
�a'IP , ' c
, Plumbing Permit
m Heating Permit
to '=j M Sewage Permit
!'L' ,4
PI Plans Received
\,
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
=
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SOUTH
I hereby certify information subsi te' is correct and there are no other structures located on this property except
as shown. --1 _,ier 2_ -- V `
6- /
Owner or Agent Date
.A LA D SE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS I NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be 2-/ A .40 e ' • .e zone is
Sewage Permit Number __ Issued Building Permit '7 Receipt Is411sued
-�
Remarks
-
.^ iir Ai, _____
Form 523 Bldg. Code
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