1971, 10-12 Permit App: J0948 Residence County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT me-
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 mast 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
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Name of Owner ,' ���� c O�"�ddress /� - 7 __ 4<. /_____�«la Phone �'IOc$�7�aV
Architect /67-40.10/1, Phon- _-,49A Engineer Phone
Contractor .S /y a Address Phone
Legal Description of Property (Give complete description from d ed, tax recel pt, etc.)
T 2 B.ce CA, 405/td, e."-e" veto.r. fif,�,o /rrc
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(Z, //L v 3 —3-2/4°J "V e e . 114. .241N6-7.14/-/d 2-9
DESCRIPTION OF WORK:New- 1_1'.'_'..-- Addit' Remodel Moving Bid Bld,e.Zone �+ Fire Zone
Size of Lot 9' X / 419 p I's"S ` ySe age System #" c /�N/11 Storm ,///tom
Const. //p�"i Dimensions .- Li/ivf JX"9- I "s Z i k X'Total Sq. Ft. /173 Valuation 1 57sb•
(Frame,concrete,brick,etc.)
Rooms -.6-- Baths -A-- Basement H AL Foundation Const. e6-/erL re, Chimney .`-'. ` ' Fireplace
(Full, part, none) (Kind) (Number)
Heat. System AA. trAS Type of Roofing C%ee1/°Os/270ext. Finish 116fM40M'4 -5/1✓6V4/ Int. Wall Finish 24 Ylei11..41:
Use of Bldg. "e.2 11)elver G.. No. of Units ./ Bedrooms .3
Garage or Carport Attached n- G°Ota,n 4 y`TA cine C 1) 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-
and water supply lines.
(ffi
NORTH State License No.
tee)
Z- -a.- 3 _ 0 1 - 7C, 2,5
/241-/$4-
�, Ind. Ins. Acct. No.
.Set �-r s �d /2.c.,>` /I 4 $ a7/ " 6
REQUIRED f
Plumbing PermitI Te'e 40 oV fir'
n+ Heating Permit S/21 Ph/ f So'r`r
m a ,p /J
N to Sewage Permit �!4'�.1 Y `AI el or Z eft/
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Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
OUTH
I hereby cert' S� nforP- ion submitted is correct and there are no other structures located onthisproperty except
as shown. � , r %....--
� i, �� /?/� - 7
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 BELOWpTHIS LINE
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Your street address will be : //G 0 3 - 3 ' Zhe zone is
Permit Number Issued Building Permit4g +lJ Receipt' 4/17411J___(RemarksT
Form 523 Bldg. Code
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