1972, 03-17 Permit App: J2195 AdditionCounty of Spokane; @Nashington
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 mast 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 veter 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 OP 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 Ild BELOW THIS LIN
Mame of Owner
dress
Architect Phone 1 Engineer Phone
/
Contractor � Address Phone
Legal Description of Property (Give com9lete description from deed, tax receipt, etc.) ..4col/i7 C5'
22 a 6.sy3 _030y
Remodel Moving Bldg. Zone ( Fire zone 3'
Sewage System Stories
Total Sq Ft. / I Valuation Att. /J
Phone -s ��
DESCRIPTION OF WORK:. New Addition
Size of Lot Ci /4-1,.i
Const L---- Dimensions TO `� r )
(Frame, concrete, brick, etc.) /�' .--�—
Rooms—/Baths Basement Foundation Const (ic-c.- Chimney Fireplace
(Full, part, none) (Kind) (Number)
Heat. System Type of Roofing Ext Finish Int Wall Finish r
Use of Bldg. t. cc' s.0 ?$ -Oil Ir
Cn • e or Carport Attached
PLOT PLAN
aw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location ofiexisting and
osed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
No. of Units Bedrooms
Private Detatched
00
NORTH
SOUTH
a shown.
I herr ertify ' f oration sub ad i correct and there are no other structures located on this property except)
Own r or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
DO NOT WRITE BELOW THIS LIRE
Your street address will be -2 -/ 2 -el 66„,2-a-/ /Se zone 1s
Sewage Permit Number Issued Building Perini( Receipt
Remarks
Form 523 Bldg. Code
2i
2
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