1972, 06-02 Permit App: J3243 Residence County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201 ��
APPLICATION FOR LAND USE OR STRUCTURE PERMIT)
GENERAL REQUIREMENTS PERMIT FEE ii
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any
nd or alter any building or structure already erected, or to change a land use. Construction must conform with the
okane County Building Code and Zoning Ordinance. Construction is subject to inspection. 4
TEL Water supply must be approved by the County and State Health Departments. Where work on water connections disturbs
he 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.
i MOVING OF BUILDINGS. A permit is required to move an existing building. When a building is moved on a County or State
t 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 IN BELOW THIS LINE --6 CName of Owner /. _ _ ^ . . ' •ddress 71.- / 2- �7.. lA a IA Cl, Phone £'4.4/-4 i'aQ
l
Architect_Z�/41. ro- eY, Phone Engineer ✓ Phone
Contractor Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) _
40
_ _ 2 3J 2 - 0zi6 - ,
DESCRIPTION OF 71:)RK:New k".1.-Addition Remodel Moving Bldg.Zone / Fire Zone j
Size of Lots X /` 1 X 7 Sewage System ire' .J °< Stories /
Const. ,P ,-P-'2 Dimensions 5) X 4 Total Sq. Ft. /.2 T Valuation /7 160
(Frame,co trete,brick,etc.) 111/7 Rooms -tom Baths / Basement Foundation Const.6 4 C r'e re- Chimney 214416-1 Fireplace '✓�
(Full, part, none) (Kind) (Nu •ber)
Heat. System s Type of Roofing C. z1 j`�/)s Ext. Finishl' t r 1,,TInt. Wall Finish .V — (,r ('
Use of Bldg. jE ¶ c &t - / No. of Units / Bedrooms
Garage or Carport Attached A�"/'r- / ` 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.
I' NORTH , State Lice No.
I Ind. Ins. Acct. No.
i
REQ ED
Plumbing Fermi 4,^•-•--
i ti {)s m Heating Permit
$—
m
�^ , _.._..... - N Sewage Permit
In`fr 2!ll'1 Plans Received i
tN .4( 140,4 5�, Plans Checked
1 1 T Plans Returned
i.
„( Plans Picked Up
iLePlans Mailed
1
— re_' SOUTH
I hereby cert" y information submit ed is correct and there are no other structures located on this property except
as shown.
• 6...."1-1.4-94...111--- ,..,...r--1-1, --1/7-404&-,e4...4-rt -61-V-7
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
'7741 , /DO NOT WRITE BELOW THIS LINE
Your street address will be / � �/ The zone is
Sewage Permit Number Issued Building Permi Receiptslued
Remarks -yZ� 1f
Form 523 Bldg. Code
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SARGENT, AMER & ASSOCIATES, INC.
CIVIL ENINEERING & LAND SURVEYING
1
1 NO. 1O1 S NEWPORT HWY. HU.7-1658
SPOT ANE, WASHINGTON 99218
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