1976, 04-12 Permit App: L3761 Pool Ct ainty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 ] / D,,0
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE.- / Of
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PERMIT REQUIRED. A land use or structure permit is required by County Resolution to 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 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.
`1 APPLICANT FILL IN BELOW THIS LINE r e�O14
/� q
\11 - ' Name of Owner( . / ` � �r Address )C'x �� `� '�ryi l S�
��y � '�-`� � Phone �-� �'
Architect Address Phone
Engineer , �' .--r---1 Address --� Phone f
Contractor Address '// ' -'- C Phone</1/_ /5(
Legal Descrip ion .f/Property (Give complete descripti from deed, tax receipt, tc.) i" , i / • 47--.1---47--.1---1-- f -'
` � , - ' - e
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone / Fire Zone
Size of Lot 4, U ` /G 2, Sewage System �y+onst.
)Fr., Conc., Br., etc.)
Stories Dimensions /6 aC i1 ')--1 Total Sq. Ft. 5-1 .,)- Valuationo
Rooms Baths , Basement Foundation Const. Chimney Fireplace
Full, part, none) (Kind) (Number
Heat. System Type of Ro5fing Ext. Finish Int. Wall Finish
Use of Bldg. -24,..-4,---r-A...-,,,L,-,_- .- No. of Units_Bedrooms
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.
11 NORTH RESIDENTIAL - COMMERCIAL (Rte/License No.
1 -6' /7 4% -�'
6§. ns''Acct. No.
4
c/�n4 REQUIRED
Plumbing Permit
m Heating Permit
rj H Sewage Permit
-r r /� ±._A_3.)--
ac -I
N
Plans Received
/�\ Plans Checked
OPlans Returned
4) Plans Picked Up
4 Plans Mailed
/G .-
SOUTH
I her certify inforuiat"o bmitted is correct and there are no other structures ocate on this property except
as shown. ...„tir }
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rc -,t .4 /� /2-- 74,
Owner dr Agent ( Da e
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 JP / q G c7 14 The zone is
�-LL 1
Sewage Permit Number Issued Building Permi U2( Receipt . ♦ Issued
Remarks ���'llllll
Form 523 Bldg. Code