1972, 11-16 Permit App: K77 Residence County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 9920
APPLICATION FOR LAND USE OR STRUCTURE PERMIT �- 0
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.
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 IN BELOW THIS LINE% 0y,ts�
Name of Owner • __ r_i_ ti./ - . ,-. •ddress ( ,/lam' .._, _ Phone
Architect Phone Engineer Phone
Contractor Address Phone
egal Description of;roperty (Give complete descAt'ption/ rom deed, tax r' ei.t, etc.) LJ `'``4_.e.ekV--g--- (-0 C`� _ _ _ . d G AC - _
i r in-d'1"-•=2--f- P
DESCRIPTION OF ORK:New Addition Remodel Moving Bldg.Zoe l Fire Zone 3
Size of Lot ft 5� nt J� / Sewage Systems' Stories��./
/
Const.rDimensions 7 d I o Total Sq.Ft. /! da Valuation yC7 . ,0 0,.I �
(Frame,coecrete,brick,etc.) p r
Rooms Baths Basementour a ion Const. _____//� �,� i, e!" Fireplace Oi
(Full, part, none) / (Ki02_,nd) (Number)
Heat. S m Type of Roofing ..liw. . . f.•-- Ext. Finish _ Int. Wall Finish C
Use of Bldg. Cr " * No. of Units Bedrooms
Garage or Carport Attached Private Detatched
PLOT PLAN 'e' ''f
Draw sketch with dimensions showing: (1) property lines; (2) street or road locatio ; (3) locate o existing and
u oposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) loca ion. of sewage sys-
te.! and water supply lines. $a- A\
"' NORTH 'r _
t .• im--
0. 1
REQUIRED
Plumbing Permit
in Heating Permit
m a
N i Sewage Permit
i, .�
i ,, e Plans Received ...411111111
L 1. f'1,_ I,., Plans Checked
+r-
Plans Returned
Plans Picked •
j 7 Plans Maile•
4
SOUTH
^ I hereby certify in ,rmatior -1311/
`tted is correct and there are no other structures located on this property except
as shown. /
.... --, J_.4 c i-..l 1 1 ( I4 -) Z
Owner or •�•nt Date
A LAND USE OR STRUCT. RE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
/ e���
Your street address will be . , _ 4k The zone is � �a- tet �-`"'
Sewage Per t Number Issued 72-3
Building Permit x._/ Receipt
i2 ( sued
Form 523 Bldg. Code