1971, 01-05 Permit App: J3264 Remodel1
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. 45-133 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.
Name of Owne
Architect
Contractor
APPLICANT FILL IN BELOW THIS LINE
Phone
Address '6.2 Phone4-h-4' /7 ST/
gineer Phone
Address Phone
Legal De iptn of perty v omplete desc ption from deed, ta71 r9ge lot, etc.)
DESCRIPTION OF WOR . New) Addition (Remodel Moving Bldg Zone Fire Zone
Size of Lot .3 _ `_--..." Sewage System- i Wiles
/ po
Const. .32c i Dimensions Total Sq. Ft. Valuatio#j7 5 O z
(Frame, concrete, brick, etc.)
Rooms Baths
Heat. System
Use of Bldg.
Dc o
eo
Basement
(Full, part, none)
Type of Roofing
A-4 t�� Y A -en �I . t
Foundation Const
pltaNAched
Chimney Fireplace
(Kind) (Number)
Ext Finish Int Wall Finish
it, l , 0 P fT ��'� ' No. of Units Bedrooms
( 0
Draw slleich with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
rn
y
NORTH
Private Detatched
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
nn Heating Permit Its
Sewage Permit
Plans Received
Plans Checked
Plans Returned
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 shotp'71
; Y-577/
Owner or Agent 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 "e9 0 St ,e zone is ` /�
Sewage Permit Number Issued Building Permit - Receipt 2 fi Is� 11../ y
Remarks U / /l''6f
Forrn 523 Bldg. Code