1971, 11-16 Permit App: J1354 MHr Y.
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE. SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
IG
o
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
which are enforceable through civil action. County Officials can not bring action to enforce covenants or
APPLICANT FILL IN BELOW THIS LINE
Name of Owner � ¢--� Address
Phone
Architect_ I MIKE cHASTEK Phone Engineer Phone
Address Phone
Contractor
Legal Descr
E. 19224 Montgomery
Otis Orchard, Wash. 99027
complete des
s
DESCRIPTION OF WORK: New
Size of,.I.gt '7 or [Pi
Const ` Jta'n e- Dimensions
(Frame, concrete, brick, etc.)
Rooms5 Baths
Hevzt. System
Use of Bldg.
GA -age or Carport Attached
ription from
i.
Addition
Remodel
deed, is recei� e.
with the land
dedications.
7z- X383
Moving Bldg. Zon
Sewage System J/11 C
%'ZD
Basement &Ja Foundation Const
(Full, part, none)
T pe of Roofing ,ExFinish
IVU
Total Sq. Ft.
Chimney
Fire Zone
Stories„
Valuation ir
AnFireplace
(Kind) (Nu fiber)
Int. Wall Finish 0 OW
No. of U 11ts / Bedrooms Z
Ib
N"
Private Detatched
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage
tem and water supply lines.
m
in
NORTH
42)00-k.
SOUTH
and
sys-
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
I hereby certify information submitted 's correct and there are no other structure
as shown.
located on this property except
Owner oi' Agent D'te
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
Sewage Permit Number Issued
Remarks
ttc
Buil.ing Permit
e zone is ^i
,eceipt 3 871
1
Issued
Fern, A92 aia., r...4.