1971, 06-01 Permit App MH County of Spokane, Washington
t BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHING?
ON APPLICATION FOR LAND USE OR STRUCTURE PERMIT GENERAL REQUIREMENTS
PERMIT REQUIRED. A land use or structure PERMIT FEE..__Ia.
kind or alter any building or structure palreadyserected, orred y touchangety sal land nuse.to erConstruction ect a nmust conform rwith t�
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
Name of Owner ��d'. L 0,.. ( 4
Address / -"' � �-�- y S 1,3 0 Phone Phone
Contractor Engineer Phone
Address Phone
Lega cription Property (Giv o ete description fro deyd,
L , _�?% _ may, Q rec ipt, etc.)
/j c2 V _ cy �}, -
DESCRIPTION OF WORK:New 1.'''.---'Addition
Size of Lot L k // Remodel Moving Bldg.Zo
/ Fire Zone
Cons � . 5` X / O Sewage System ���!« 0� Stgries
Dimensions Total Sq. Ft. 3�)
(Frame,co Crete,brick,etc.) Valuation �Cce 01
Rooms Baths _ `�
Basement Foundation Const.
(Full, part, none) j, �+ Chimney Fireplace
Heat. System Type of Roofing � �° `.( (Kind) (Number)
Use of Bldg. � � � j,�, Ext. Finish Int. Wall Finish
Garage or Carport Attached No. of Units Bedrooms•
L----
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-
tem and water supply lines.
NORTH State License No.
Inn'. Ins. Acct. No.
2.1t4}' ' W(-Pe'64 .
'^ ns
REQUIRED
Plumbing Permit 5
Heating Permit
tit
Sewage Permit
1
Plans Received
Plans Checked
1 Plans Returned
1 Plans Picked Up
Plans Mailed
SOUTH
•
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown.
6 -/ 7/
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DON RITE BEL ',THIS LINE
Your street address wil
Sewage Permit Number The zone is OAP..., ` 77_ p �F
Issued Building Permit ReceiptCci9 7 Issued
Remarks T y701d
,,.��,A �/ /ss y _ .4,
.7 // o
Form S23 Rlrh ('..a- I L U�"/ �
d
O 1 U1,MMAN ROAD
�St r
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S, 9-12 DIS NIAN ROAD