1972, 10-18 Permit App: J4808 RemodelCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT ' e, _
GENERAL REQUIREMENTSPERMIT FEE e
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 THIS LINE
Name of Owne
Architect
Contractor
Legal Descriptio of Property
t- Gym e 4;
ddre .Z'yfG i �4.�� J / Ph one WA T'`%-8if 96
Phone Engineer Phone
Address
-
, .r
(Giv complete. descri tion from deed,
EEC: RA OLE
DESCRIPTION OF WORK: New
Size of t ` / 7,5
Cons-�li� %yf k! _ Dimensions /o X AM
(Frame, concrete, brick, etc.) ( '�-�-
4t
Rooms 4 Baths Basements 4' Foundation Const
(Full, part, none)
Type of f oofing
tax receipt, etc.),
j%/.e
Addition Remodel
Moving Bld Zones f
Sewage System
Total Sq. Ft.
Heat. System
Use of Bldg.
Chimney
Fire Zone
Stories
Valuation dO
0
(Kind)
Ext,'inish /J S Int. Wall Finish
ta44FLAn X. / No. of Units
Private Uet✓✓✓adched
Fireplace
/.) (Nu ber)
AleZ xkL t
Bedrooms
Garage or Carport Attached
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.
NORTH
SOUTH
I herebyiertify information submitt
as shown.
✓JC
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Receive
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
is correct and there are no other structures located on this
/e) --
property
except
,Owner of 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
it ' irf
Your street address will be 7i.�
Sewage Permit Number Issued B ilding Pe
Remarks
Form 523 BIdo. Code