1971, 03-25 Permit App: I3801 Addition9
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
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 onwater 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. 45-133and47.235.
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.' Wherethestructure 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 ownerec��72c.-e--"— c--• Address
Architect Phone _Engineer Phone
Contractor Address Phone
Legal Des ription o Property (Give complete description from deed, tax receipt, etc.)
Age
9 2
??o 3 7
.., 3 0 5 Phone/, /a.'4/
,--6 s y- ? -
DESCRIPTION OF WORK: New
Size of 171 T/4ar4
Const. - P Dimensions
(Frame, co%crete, brick, etc.)
Rooms s Baths
Addition �L
Remodel
Moving Bldg. Zone 1 Fire Zone
Sewage System —�' Sto 'es
Total Sq Ft �/ 6 Valuatio 250 0
Basement Foundation Const
(Full, part, none)
Heat. System Type of Roofing
Use of Bldg. GGGA/i//C
Garage or Carport Attached
Chimney Fireplace
(Kind) (Number)
Ext Finist Int. Wall Finish
No of Units Bedrooms
Private Dotat ched
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,
SOUTH
I hereby ce , y information submitted
as shown.
s
y
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
correct and there are no other structures located on this property except
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTIO
THIS 1S NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
COMMENCES.
Your street address will be !�Q ' D� —5---,/S.-9112-1The zone
Sewage Permit Number Issued Building Permi� fa Receipt
Remarks /
Form 523 Bldg. Code