1972, 10-17 Permit App: J4872 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
q�Y
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 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 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.
APPLICANT FILL IN BELOW HIS I IIjE
Name of Owner o-�j-[i —Address 1l 443/% i� -› (:)<YAJ"-Phone (v 6y-- 'tea 0-V
Architect Phone _Engineer Phone
Contractor %amt, e Address 8...e.:/-/ 5 / - ��„1 ` Phone 773L-
Legal Description of Property (Give compl e description from deed, tax receipt, etc.),0,4.1" `� — ��7�i-✓� /
kJ rL f (f1' /
DESCRIPTION WORK: New r/ Addition
Size of Lot Jkb
Const Dimensions IcY )(,sN — 6 f a a.
Remodel
Moving Bldg. Zone I
(Frame, concrete, brick, etc.)
Rooms 4 Baths Q Basement fu I / Foundation Const
(Full, part, none)
Heat. System g .(u a. Type of Roofing
Use of Bldg. rim, ep
Garage or Carport Attached
Fire Zone
Sewage System gop7; c T-Ccn k Stories /
Total Sq. Ft. 3/ 0 Valuationst/.t o o D
('o n r ✓-€ TR-
Ext.
eExt. Finish
Chimney/4 6 - Fireplace /
(Kind) (Numb r)
Int. Wall Finish oUQ
No. of Units Bedrooms .3
Private I)etatched
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.
m
NORTH
I here
as shown.
fy infor
SOUTH
mitt -d
s
correct and there are no other
Owne or Agent
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
structures located on this property except
/o 7- 7;
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMIT.
(9-/v 1.
f Your street address will be
Sewage Permit Number Issued
Remarks
DO NOT WRITE BELOW THIS LINE
Date
CONSTRUCTION COMMENCES.
Building Pe it
7? -
e zone is (2
Receipt 9 70 7 ' Issued
Form 523 Bldg. Code