1975, 03-20 Permit App: K6971 Residence•
APPROVED AS N
Spokane ounkjit3MGCtibpstfrE
Date
y of Spokane. Washington
RTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
6.0
FOR LAND USE OR STRUCTURE PERMIT
T S PERMIT FEE _
IT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or'structure of any
ind or alter any building or structure already erected, or to change a land use. Construction must conform with the?
jpokane 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.
FILL IN BELOW THIS LINE � '%�?�,��
Address f' i 1 4°1C)—
r-Ti A'Gta- Phone! r 9 -3 ' 1 L
1
Name of Owne
0
APPLICANT
Architect Address,,q� Phone
Engineer . Address rPhone( c
Contractor) Address P. .--/ I D ' b --304'-• ''�j% '34 Phone T 2 -St T +3 0 L 2-
J�,rh'.�-6-//? et9 -
OS(oU.- ,
CS
Legal Description of Propert (Give complete description from deed, tax ceipt, etc )
DESCRIPTION OF WORK: New L Addition Remodel
Size of Lot I oo ' .X 1 3 v'
Stories.)--. Dimensions 6q / x a /S1.135113 - ¢00- G 6 /
Rooms 7 Baths• Basement Foundation Const
Fu I. part, non
Heat. System i/r . Type of Roofing -EY. Finish
Use of Bldg. � C...<9,19
eof
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.
Moving Bldg. Zone / Fire Zone `3
Sewage System S r Const. �✓-� *-F-7 `�
i as', ,16 IFr., Conc. retc.)
r..,
-11.. Total Sq FtY� � ,gValuationOid��
e Chimney Fireplace �'
(Kind► (Num
ttpnt/
Int. Wall Finishes - -
No. of Units _ Bedrooms
m
to
NORTH
pIpt�her by certif
SOUTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
submitted is • r •ct and there are no other structures located on this property except
as
O-
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
MIS IS NOT A PERMIT.
("AA, ?l4
Your street address will be (67, // d / , 3 /.-07 t ��-
Sewage Permit Number Issued Building Permit,
Remarks
Owner or Age
DO NOT WRITE BELOW THIS LINE
The zone is
Receipt 74.0 'Issued
Cv•it --isi2-.4-00,7
Form 523 Bldg. Code
WESTON D. OGZEWALLA, Agent
Auto - Life - Health - Home and Business
3(° ue
/00
South 104 Dartmouth Road
Spokane, Washington 99206
Phone: Off: 928-0560 Res: WA 4-3012
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CVO MEM.
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