1972, 04-18 Permit App: J2655 MH-NOW 'war
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT1 O 0
GENERAL REQUIREMENTS PERMIT FEE //
PERMIT REQUIRED. A lind use or structure permit is required by County Resolution to erect a building or structure of guy
kind or alter any building or structure already erected, or to change a land use. Construction mast conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to Inspection.
MATER. Fater supply must be approved by the County and State Health Departments. Where fork 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 fork 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 laud
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner �./� I .� ddress q / 0'A �rd M^o^�w'rJ Phone
Architect Phone Engineer Phone
Contractor Addressn Phon
G1iee
Legal Description of Property (comple a deartoll = eek i receipt, etc.SAY.LL a93)- 37/ 3 - 97/4
WA- 4S/3di
\DESCRIPTION OF WORK• New /0"-- Addition Remodel
C�3 o[Lot 9 X/A7
imensions /A X.TOy � �--}
(Foams, concrete, brick, etc.) (I I n
Rooms .Baths �—Basementlvo) FoundationiConst —A/- / Chimney (Kind)
Heat. System f Type of Roofing ' 1p A.Q L Ext Finish 1i1 Q.(. Int. Wall Finish
Use of Bldg. S- /Sit-t.f P.f-1 ae ..10.14.0-r e, nt-QAi it..I4."1 . No. of Units
Garage or Carport Attached Private Detatched
Moving BIdgg0Zone- �_ Fire Zone
Sewage System 04 t40iWl.r. Stories ]
Total Sq Ft. •SAO Y Valuation OO
Fireplace —
(Number)
ELM it
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.
NORTH
)gst. coax -Let
40/14
SOUTH
I hereby certify 1, oramtion submitte
Owner or Agent
A GSD USE OR STRUCTURE PERMIT MUST BE 014 THE PREMISES BEFORE CONSTRUCTION- COMMENCES
THIS IS NOT A PERMIT.
yS shorn.
State License No.
o Pr
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit t•
on Heating Permit
se Sewage Permit
.4
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
is correct and there are no other structures located on this property except
DO NOT WRITE BELOW THIS LINE
Your street address w111 be 7/ o 7 e7744A-Q_
sewage Permit Number�— Issued
Remarks .f,C.�-hrll iY a-rri7Y1a-p
Building Perri
e zone
Receipt 9361 Issued
Form 523 Bldg. Cods
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