1971, 11-03 Permit: J1200 Residence0
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County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401 U
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.
NATER. 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
Name of Owner �'�' / ' ddress S.-Z�-�� Gli/A W (,I t;ZZ6 Phone
Architect Pho a Engineer Phone
_.,. _lsr i' 7
Contractor iiig _ dress -�.�. -� � �� ��/+�_ Phone„11al_
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
7-6
DESCRIPTION OF WORK: New �i_ Addition Remodel Moving Bld . Zone / Fire Zone
Size of Lot /3Sewage System c-1 •✓ 'I1/4 Stories I
Const. Fj-� Dimensions �� ii Total Sq. Ft. Valuation 000
iFrame, concrete, brick, etc.) CO
Rooms &3 Baths s� Basement /
Foundation Const. ` )'1 C; i- ��P Chimney ]Fireplace
(Full, part, none) (Kind) (Number)
Heat. System a � d �` O Y� ` '' t� A
Type of Roofing .a �/ Ext. Finish �o. .�/c1�y � Int. Wall Finish-S&Q�%,-�o
.r 3
Use of Bldg.. S /1to ic FA M1 l y JAW e1h h 9 No. of Units Bedrooms
Garage or Carport Attached
M
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.
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I hereby certif informat
as shown.
State License No.
Z'3 a1 //-2-S
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit Noe //e- r
F” Heating Permit � m I %h so w-5
wSewage Permits •� �' �(
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
correct and there are no other structures located on this property except
(/ /l- 3- Z
ner or Agent Date
A LAND USE OR tTRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
Form 523 Bldg. Code
Issued
DO NOT WRITE BELOW THIS LINE
Building Permit
The zone is )&"CA_
Receip04-� % Issued