1972, 03-28 Permit App: J2360 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT Jr .50
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 most 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. 95-133 and 47.235.
SET -RACK 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 1s 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 car. not bring action to enforce covenants or dedications.
Name of Owner
APPLICANT FILL IN BELOW THIS LINE
:17,1111,111E4111101,1,1111,
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ddress .2
gozd3
Phone HA - -644/
Architect Phone Engineer Phone
Contractor Address nn nPhopeb
Legal Description of Property (Give complete description from deed, tax receipt, etc.) .Y[I.H°LQ.- -1' 0 S4 4 - J2 i 7
DESCRIPTION OF WORK: New I Addition 7�— Remodel
Sue of t i49 ,X/zo C% / 4.CI.L'Li�J�-
Const ''�Cv62✓1 Dimensions
�/X Total Sq Ft. It 7 Valuation i04 of
(Frame, concrete, brick, etc.) p �7 /� �-/- 14rea J
Rooms Z Baths / Basementp2d//Foundation Const ( 1 -"it C'.fA-('it.PJ Chimney r - Fireplace J (Full, part, none) /)` (Kind) (Nu r)
Heat. Syste , O - .I Type Rooting/ ( .(1•il/Lt1Q Ext Finish -4; 444 --ii it /Int Wall Finish
Use of Bldg. /1-4.4- 4) 0.A'J4.( g....1C,I
Garage or Carport Attached
Moving Blg. Zonee1 .. Fire Zone :9
Sewage System , 1 lat i Stories
No. of Units Bedrooms
Private Detatched
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location ofresisting 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
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State License No.
GIC
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
M
Sewage Permit ✓
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
t and there are no other structures located on this property except
Owner or A:• nt 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
Oil
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Sewage Permit Number Issued Building Perm
Remarks
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Receipt r1 04 Issued
form 523 Bldg. Code
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