1971, 02-24 Permit App: J3761 Residence1 0 0
County of Spokane, Washington Id
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
1-7
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 kP.4e-1v�'--- ddress baa 1.1/1 vee5 i �y Phon
-a 7?
Architect Phone Engineer Phone
Contractor ,}P&A) e0/15_. .-ice /%C . Address /Qa At. rl/ k, �t5 _ Phone 404- "d %%/
Legal Description of Property (Give co lete description from deed, to receipt, etc.)
A4,154 4d,36J1-/,nM
DESCRIPTION OF WORK: New Y Addition Remodel Moving Bldg. Zone Fire Zone
Size of Lot ��X ��(c.%b, X so, X %g%.8 Sewage SystemSGW tories
Const.-RAML Dimensions S1% X ay Total Sq. Ft. `ag4v Valuation d
(Frame, concrete, brick, etc.) J
Rooms- & Baths Basement�u// Foundation Const. eU/ULI Ri= %�_ Chimney 1 G�` Fireplace '
1 (Full, part, none) (Kind) (N er)
Heat. System �� r Type of Roofing ��%7� Ext. Finish f� _ Int. Wall Finish
Use of Bldg. i �'! 4 �j L'5% deme -e- No. of Units Bedrooms
rage or Carport Attached Q A'a - Private Detatched
19
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations;
pr osed buildings; (4) distance to property and streets; (5) dimensions of buildings;
em and water supply lines. 3[T/
(3) location of existing and
(6) location of sewage sys-
� State License No.
NORTH/
Ind. Ins. Acct. No.
REQUIR 0Plumbing Permit `i1(
\ern Heating Permit
(A N Sewage Permit
-1
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
OUTH
I hereby certify information s bmitted is correct and there are no other structures located on this property except
as show
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
Your street address will be
Sewage Permit Number
Remarks
Form 523 Bldg. Code
/ / /
Issued
e zone is�
Building Permit Receipt '6 r:_ Issued