1971, 05-04 Permit Application: ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 9920
APPLICATION FOR LAND USE OR STRUCTURE PERMM
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.
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 I(�.
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.
ilders should check provisions of covenants or dedications and easements running
which rR en r able i ou —id action. County Officials can not bring action to enforce covenants or
li
Name of Owner
APPLICANT FILL IN BELOIIM, THIS LINE
ddress
,)
with the land
dedications,
one
Architect Phone Engineer Phone
Phone
Contractor i
Legal Description of •roperty (Give complete description from deed, tax receipt, etc.)
Address
DESCRIPTION OF WORK:, New
Size of Lot I ��l 7� 5 ,
Const. I Dimensions Y
Addition
Remo
(Frame, concrete, brick, etc.)
Rooms Bath Basement / Foundation Const
(Full, part, none)
Type of Roofi
Heat. System
Use of Bldg. (
Garage or Carport Attached
Bldg. Zone / Fire Zone 3
Sewage System z� — Stories
Total Sq Ft .s2_Valuation 3o 0Z-L/
- M C:i,Z2 Chimney
Ext Finish
PLOT PLAN
Fireplace
(Kind) (Number)
Int. Wall Finish
No of Units Bedrooms
Private Detatched
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
6
- C
7 1
r r
Ji
6 7
a
I hereby
as shown.
SOUTH
ify information ub 'tte
fin,
ERM
Owner o Age
A LAND USE OR STRUCTURE IT MUST BE ON THE PREMISES
THIS IS NOT A PERMIT.
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit /' `/'t
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
is corr t and there are no other structures locate this property except
Your street address will be
Sewage Permit Number
Remarks
Date
BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS L
o� 0
e zone is
Receipt/ Is
Form 523 Bldg. Code