1973, 06-01 Permit App: K1841 Addition lr _________ _ _,_ ,
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County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE. SPOKANE. WASHINGTON 992
ti APPLICATION FOR LAND USE OR STRUCTURE PERMIT _—
GENERAL REQUIREMENTS PERMIT FE
IT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any
k nd or alter any building or structure already erected, or to change a land use. Construction must conform with the
S okane 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.
..110'. APPLICANT FILL IN BELOW THIS LINE f
Name of Owner . '• •e, rig
I .= =. , - . ' •ddress C y (c 7/ / - 7 "" '
- Phones 46 -- '�
Architect Phone Engineer Phone
Contractor Address Phone
(Legal c iiption of Property
\ QCs Prrty (Give completeAe� p on from deed, tax r_- eipt, etc.)
, .7%.S— � �C�j �` _ 1/101 HIP111011.
DESCRIPTION OF WORK:New Addition ✓ Remodel Moving Bldg.Zone 7 Fire Zone
Size of Lo/ i r5 ' V / c 2 7 ' Sewage System. ' rte..,-12.-e-7.7 -.,, Stories ��-e-G-1--/.)
C6 st. ' i. Dimensions /f fC // ( ate' Total Sq. Ft. c_. ,"?0 p VIIuation ce o.,O- 1
(Fr. ' ,concrete,brick,etc.)
Rims / Baths,.. .Basement...... .Foundation Const. -r ,i-e_-- .12' Chimney Fireplace
(Full, part, none) (Kind) (Number)
Heat. System —Type of Roofing (7_.t5-1'/�a Ext. Fini
is/sh ..-$. :2.2-e.—..",-�c�, Int. Wall.Finish
Use of Bldg. .. ��)Q�_!L_¢ No. of Units / Bedrooms
Garage or C rrport Attached ____--- e- _.-c) Private Detatched )
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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.
NORTH \ stalfi�j5e ,:.
nd. I.--1 Acct. No.
t
/ REQUIRED
i i , Plumbing Permit
* .) i , i en
� ' m Heating Permit
v+ N Sewage Permit NIL
-4 =I
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
hereby certify information submitt•• is correct and there are no other structures located on this property except
as :own. ' ` .,. I I /
Own 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
•.6 street address will be , ( ' z .\
,e zone is ii x i.'.!. __
Sewage Permit Number Issued Building Permit - Receipt.-Z.,2# Issued
Remarks ' 447 •
Form 523 Bldg. Code
. LV IN J. WOLFF $25.00 164-65R
j MAP SHOWING LOCATION OF RESIDENCE ON & BOUNDARIES OF =
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Lots 15 and 16 in Block 7 of i
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EMPIRE HEIGHTS ADDITION \ 4- -
'` \-)1.1,„;42.-
'`f e 1}- 4 71 r
in the COUNTY OF SPOKANE and STATE OF WASHINGTON
Extra charge for setting LOT markers.NO markers set Survey for Loan purposes only.
Scale 1" = 20 Ft. Surveyed: July 12 1968
I hereby certify that I surveyed the above described property and that I find the improvements to •
be on the premises in question and that they do not encroach on the property lying adjacent thereto—
EXCEPT:
NO improvements encroach on these premises—Except: C3D.,...-2j2,/::, .t
OWNER or BUYER SARGENT, RAMER & ASS CIATES, INC.
Robert P. Blout
CONSULTING CIVIL ENGINEERS & LAND SURVEYORS
East 6714-7th Avenue North 10115 Newport Highway
Spokane, Washington 99218
HU 7-1858
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