1972, 04-26 Permit App: J2739 Pool I•
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE. SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
0:-5----
GENERAL
REQUIREMENTS PERMIT FEE_
PERMIT REQUIRED. A land use or structure permit is reuuired by Co»fity Resolution to erect a building or structure of aAY
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 ROBd5, permission must be obtained from the County Knglaeerts office.
mug g8§Tgm, Permits are required in all cases by County Resolutions Non. 45-133 and47,235,
SST=BACK PROM MDMATY LIPIE�_ In moot noneo and AAUP Rl mat r8n@I�tMne€.6, a het=bnel[ from the front proporty line, or at
bast 2 ' ig requiren, a 5' side yard, is' side yard from a flanking street, and a 25' roar yard arc reauired.
SrATE HIGHWAYS. Where tfc structure abuts a state Highway, clearance must be obtained pertaining to set-back and Ingres(
ama egress.
CWUN'cy ROAM. woes as street right=ot-way may not be performed until staked by County Road Department and work must t(
it rformed in accordance with siakss. Pout* *f iHRIPHe and ugrenn munt he approved by the county engineer_
MUM VP BulLDlwc€; A powmit ie reQuired to more an existing buildink, WhAn a bii1141nis Is MAVA5 an a P89Bts AP stats
Highway_ Glc,„„, mast ti: ntilaW xraxi the county engineer anulor Mate Highway Department_
Acceegger HDILDINGS_ Accessory buildings (enrages, she(1s, Ste.) roauiro a 30parate omit.
REDTRiCTIVE COVENANTS. BDildorS gA4uid mooch provisions or covenants or dedications and easements running with the land
which are enforceable through ciiiil action. County Offieials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
�e /I - AMM
Name of Owner '� Address - .' �. Phone
Architect — 13119p Engineer Phone
Contractor ea ,- ; , / d+---c, ;"e Addressi�rc � - i-AC 'hone
Legal Description of Preferty (Give complete description from deed, tax receipt, etc.) f/I. _e)a' /. 3.1
_ /
DESCRIPTION OF WORK:New ' fAddition Remodel Moving Bldg_ one / Fire Zone 3
Size of /y
t �'0'XeC) Sewage System Stories
Cans ire new Dimensions f.5,k Total Sq.Ft. .S" 5 Valuation '?ex, °D
(Frame,concrete,brick,etc,) �� f
Rooms Baths "-- - Basement Foundation Const. ,/� ,CzC . ' ) Chimney Fireplace
(Full, part, none) (Kind) (Number)
Heat. System Type of RoofinEst. Finish �- Int, Wall Finish -`
Use of Bldg. l-e -77-14"-- ----e.� No. of Units ----Bedrooms
Garage or Carport Attached £ Private Detatehed
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 State License No.
Ind, Ina, Acct, No,
A'xj2
Olt
REQUIRED
Plumbing Permit
9)111 If m Heating Permit
P
N N Sewage Permit
-1 —I
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I here y certify information submitted is correct and there are no other structures located on this property except
as shown.
r 4► - +
Owner 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
Your street address will be _ _ -4 J/� �'�- .e zone Gis ---7/
Sewage Permit Number Issued Building Permit Receipt /�7 Issued '7
Rem ks 9
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