1972, 02-25 Permit App: J1976 Residence r -- --- .........-
County of Spokane, Waosh ngton
BUILDING CODES DEPARTMENT. COURTHOUSE. SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT ."/
ENERAL REQUIREMENTS PERMIT FEE 67j
P IT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any
k and or alter any building or structure already erected, or to change a land use. Construction must conform with the
Si.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.
APPLICANT FILL IPI BELOW THIS LINE / 0 p0
Name of Owner �Ir,�!'l li , .,.4... .4 !:.dress 6 v� . .4� Phone K�� 8 I
Architect P one Engineer_ Phone
Contractor 31j2 .Q, Address_ Phone
Legal Description of Property (Give completend
escriptio• from teed, tax receipt, etc.),�i �0 21�7 6 4 4 -Jl
1.t.,e- a 1,1.acy-d i�Atea!J —
DESCRIPTION OF WpRK:New 1.--' Addition Remodel _ Moving Bld Zone Fire Zone
Size of L /30 � ice, Sewage System sled i Stories / „U
Const. Dimensions a(o•� X 72 —/�X 4..3-/---.2O`X/O Total Sq. Ft. to s 6 Valuation ,� mod �--
(Frame, trete,brick,etc.) �( n
Rooms Baths q Basement.7ufe_Foundation Const. (74 i Chimney fireplace
I (Full, part, none)
ti
Heat. Syste W.� , (Kind) (Num er)
/ y e of Roofinga44-,re...LJ Ext. Finish Tf/l Int. Wall Finish
Use of Bldg. . 1 t../.�' 24Q"(�Gf(p
e- ____ No. of Units Bedrooms 3
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.
•RTH State License No.
4
O7 Ind. Ins. Acct. No.
REQUIRED
rami, le �(
ec u aeJ �� Plumbing Permit k-
c r2'
m Qui) rn Heating Permit
.� Yo
Sewage Permit _
5f, q4 Plans Received
(y ^ Plans Checked
0 Plans Returned
Plans Picked Up
,�.(�°. Plans Mailed
_ SOUTH
I here ce i y i .oma ion <submitted is corr t and there re no other structures located on this property except
as shown.
r a
De►ner or gent
Date
A ,AND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
et-iieu I DO NOT WRITE BELOW THIS LINf<
Your street address will be /3 , /U ey, , 4 a
e zone is 4..4244-41.221—.4.124.-,
Sewage Permit Number
Issued Building Permit Receipts ?go, Issued
Remarks
Form 523 Bldg. Code
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JOSEPH L. DICKINSON
PROFESSIONAL LAND SURVEYOR '