1971, 07-22 Permit App: J0149 Residence County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT/# �
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 pepartments, 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 gRd 47, 35.
SET-BACK PROM 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 pertaimg set-back and ingress
and egress. fs
COUNTY ROADS. Wormb 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, AeeoBeory buildings (g&rilgeS, Sheds, etc.) ro u1re a separate permit.
RESTRICTIVE COVENANTS_ Builders should check provisions of covenants or dedications and easements running with the land
which arm enroreeable through civil action. County officials oan not bring anti¢!! Ft? aufcrcy covenaata or dodisation$.
APPLICANT FILL IN EE6$W Tl1I;f LINE
Wit-1,.1/41.1 > € ddrt in `3 � =o`r's �5xr�• Mona_ -_j
architect `... coons inEinssr-_— —
ls'BBtfiistag ,s Addich7 Phone
L�&ai Description of rruoarti (Odie complain oeecriotion from anew, tna rotuipt, teteA _ = y C � �[�
{"e3 2u� A a� � firs r 40 7 J Lk I t_
�aXo 4 T7? N45rT
DESCRIPTION OF WORK:NeW_ Addition Remodel Moving Bldg.Zone Fire Zone
Size of Lot eO X /3t) Sewage System * ST/C Stories / �- •
Const. FRAMF Dimensions 7V X 4' —Total Sq. Ft. 4l(a rQ Valuation -Yc Odd
(Frame,concrete,brick,etc.)
Rooms .5 Baths 4 Basement 2- Foundation Const. eE)/1.G : Chimney igeNk Fireplace
(Full, part, none) (Kind) ( umber)
Heat. System FA 614S Type of Roofing i1Mf Ext. Finish �/C/A)�7 Int. Wall Finish 7).114/e
Use of Bldg. £'Nl/La" r-1 4�/ �jGs • No. of Units Bedrooms -4
Garage or Carport Attached .6-4/e,. A-7 i 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. Ins. Acct. No.
REQUIRED
A )�r, Plumbing Permit
m Heating Permit
m a
y, Sewage Permit A/
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown.
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 Q Q
Your street address will be 1I LO E ? " The zone is 4/ k9,Gcfie
Sewage Permit Number Issued Building Perm Receipt '7.284 Issued'"'
Remarks 64
c?
Form 523 Bldg. Code
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