1971, 04-26 Permit App: J4138 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99401
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APPLICATION FOR LAND USE OR STRUCTURE PERMIT ��5
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 LkA ot S f 1 L� ddress Phone
Architect F Pone Engineer t- Phone
Contractor h� v Hli 3r W a I I I N Address 1 S-0� �.1 Phone 1,La-6473
Legal scrip�//n
tion of Property AGive complete description from deed, tax receipt, etc.)
ct x / co I 0
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone Fire Zone
Size o of 27-0 �r Sewage System `c -At St s _�
Const. Dimensions Total Sq. Ft. /.�13 t) Valuati Z /0
(Frame, concrete, brick, etc.) 1
R oms _Baths 7� Basement F�1'� "� oundation Const. 0,0 Chimney -e�� Fireplace
46-1 ( ull, part, none)(Kind) (Kind) (Number)
at. System f < Type of Roofin �t-dw lkish S irJ Int. Wall Finish � 2 A /
Use of Bldg. ,,,, �j� r . C �— No. of Units Bedrooms �-
Garage Carport Attached Private�lletatched
PLOT PLAN 5 2-
Draw sketch with dimensions showing: (1) property lines; (2) street or road cations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensi of btoings; (6) location of sewage sys-
tem._a d water supply lines.
NORTH (} State License No.
Ind. Ins. Acct. No.
SOUTH
a
4A
I/hqlrkby certityF\iilb�ormation submitted is correct and there are no other st
as
REQUIR
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
ures located on this property except
bwner or Agent date
A LAND USE OR STRUCTURE PERMIT M ST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES. `
THIS IS NOTA PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be
Sewage Permit Number
Remarks
Form 523 Bldg. Code
1 6 3 /o
Issued
—11 P. The zone is
Building Permit Receipt