1971, 07-29 Permit App: J0215 PoolCouty of Spokane, Washington
D'
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99?A1, 3i
I
APPLICATION FOR LAND USE OR STRUCTURE EPERMI
T
GENERAL REQUIREMENTS or
RMIT FEE
PERMIT REQUIRED.
listructure
tascyucgeslnto erect
nr
kind or alter any bulding orstrucuurelreadyereted. ortohanaland use. Constructionmust conformwith the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. Water, shoulders be
Cothe unty Roads, permission and State ealth must bepobtaeined frhomre theork on Countyater Engineer'atOfficeisturbs
the surface,
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.235.
SeastACI( FROMiPROPERTY LINES.
side zones
side yardrmost from acflankingnstreet,sandback 25' rearthe
yard are required.
line,
of at
least25'Iis reS. Where STATE
HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
and egress.
performed
COUNTY ROADS.nWork on ccordanceswithtstakes.oPointsmof y iot be ngress andormed until egress mustsbekapproved Road Departmet an
Engineers work must be
uilding is
HOVIwa OncNmustAbepermit
obtainedrequired
thetCounty Engineerland/orbuil
State HighwaybDepartment,moved on a County or State
Highway, clearae
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit.
nd
RESTRICTIVE
nforce ble throughrciviluld check action. Countysions of Officialsocanants or not bringdactionns toand enforceeents covenantslng with the or dedications.
which are
APPLICANT FILL IN BELOW THIS LINE��li
Address L //1/0 7"!�---Phone WA.k —
Name of Owner : • N � e Phone
Engineer k Q�
Architect ones I, 7`�lp��Phone '%
ContractorAh,p h 57/ (Sc ',/Ices )NG Address /P • .4• o /) hi gh- r ?- ��'
Legal Description of Property Give complete description from deed, tax receipt, etc.)/ TA e , � 7 P ��, gym,
paii1Sl�i , Net Th
GnveiNiNe�'vT �rai j 1N .Sr�c"?/'oI/ � here � y o���� --90��
oral00 Jt 7
1
DESCRIPTION OF WORK: New_l___ Addition Remodel Moving Bldg. Zone / Fire Zone
Sewage System &/. Stories
Size of Lot `/ , . f 3 91 i% 2 Valuation 13�0a (�
i VIA t Dimensions / [9 A Total Sq. Ft
Const.WC�a{ 1�
(Frame, concrete', brick, etc.) Chimney Fireplace
Rooms Baths Basement Foundation Const. (Kind) (Number)
Heat. System
('F�ul�l,, part, none) Int. Wall Finish
..i�Type
of Roofing Ext. Finish
(�"`�''�
Peel No. of Units Bedrooms
Use of Bldg.
PLOT PLAN
and
Draw ed buildings; (4)mdistancestow
property linesrand 1) propety lstreets; (5)ines; (2) rdimensions of buildings; eet or road locatins; ((6)3) l location ofocation of existing
proposed
and water supply lines. State License No.
T g3 -'i 52L3
Ind. Ins. Acct. No.
z
50att1
/O
j-�ott$ e
GIP/ cP3o
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
4 . / .r•H /O
ISUIN Matli
I hereby certify information submitted is correct and there are no other structures located on this property except
c�
as shown. •720 ° _.. , 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 BELOW THIS LINE
Your street address will be
Sewage Permit Number Issued Building Permi
Remarks
'he zone i
Receipt 73`36 Issued 7 -.*..1'-7/
Form 523 Bldg. Code