1972, 02-25 Permit App: J1977 Residence • County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE. SPOKANE. WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 36 v 6
GENERAL REQUIREMENTS PERMIT FEE
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.
WAT .R. water supply must be approved by the County and State Health Departments. Where work on water connections disturb
t e�srface, 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. 1
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 $nnd Ingres$
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.
APPLICANT FILL IN BELOW THIS LINE -4 ,j + qg 2 '
// o / Phone f( ' 3 I
Name of Owner 4}�.uvcY� 40. . tll.14/.44hddress i i L��
Architect_ Phone Engineer Phone
Contract or.44,0.."14/LL Address /�-- PhoneP/
Legal Description of Property (Give complete description from deed, tax receipt, etc.)./0-47---1-"C-1/• ±-0.2:76---1-M- /1-2-0
DESCRIPTION OF WORK:New Addition Remodel Moving Bldg Zone Fire Zone `�
Size of t J S3 / �(
/Sewage System " �� Stories a
Const Dimensions Aiii416 34;6-k 4'6--23-1 Ji Z.34 Total Sq. Ft...211. Valuation 3O)()Oa(Frame,co crete,brick,etc.)
Rooms_ Baths Basement foundation Const. l���t iZ Chimne replace
,r� (Full, part, none) (Number)
Heat.J e o T e of Rpo/fing e_.,— 4't1Q _ Ext. Finish 7-7// Int. Wall Finish
Use of Bldg.ii7;r4)-ttZZ. �JAA.!il �'/14-,c-4✓ No. of Units Bedrooms S
Garage or Carport Attached 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.
NORTHtl/f� State License No.
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'°.(f 9q.' .' Ind. Ins. Acct. No.
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REQUIRED
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*10-1Plumbing Permit 1/
rw Heating Permit I/
„„ * /i
y� Sewage Permit
Plans Received
I6 • Plans Checked
1AI Plans Returned
,\ Plans Picked Up
tanr� ' Plans Mailed
i
_\ SOUTH
as show heptbil cinto maion submitted is corr�-ct and there are no other structures located on this property except
Owner or A:ent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
ilal. --)46/,/ A* DO NOT WRITE BELOW THIS LINE
s
Jour street address will be )',5 -2 6 e ,Q.}-i,v . Lt/ The zone is li .1,_..4 . .4 ."
Sewage Permit Number Issued Building Permit )J.c Receipt h'7 g _Issued .6
Remarks _
Form 523 Bldg. Code
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,/�,/sir Le r JOSEPH L. DICKINSON
�4 PROFESSIONAL LAND SUIVE`YOR
4F 10364 ep/ '�
C Es .`'. E. 0616
✓� s MONTGOMERY
� �, ERY
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.�' Spokane,
�c� ''� ll�t�� p ne, Wash. 99206