1974, 07-08 Permit App: K5171 AdditionCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99204
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 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, hnd 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.
PPLICANT FILL IN BELOW THIS LINE
Name of Owner
Architect / 1
Engineer
Contractor
Legal Description
Address GL
Address
Address — _
Address ) / ' col
l
of Proper, (Give complete description from deed, tax receipt, etc.)
,G f( 7 _ 6D- °y
4
Phone
41:1121+5 9ya. 0 7
Phone t/
Phone )J�' /` ' 7 73
z_
DESCRIPTION OF WORK: New
Size of Lot
Addition
Remodel Moving Bldg. Zone / Fire Z
Sewage System • --''"--� Const.
/ (Fr., Co ., Br., etc.)
Total Sq. Ft / 3 ct Valuation 1 A
Chimney Fireplace
(Kind) (Number
. Ext. Finish 7L / / ( Int. Wall Finish
Stories Dimensions (s X 0. a -
Rooms _L _ Baths Basement
(Full, part, none)
Heat. System Type of R fing
Use of Bldg. / �%r
Foundation Const.
3
PLOT PLAN
No. of Units_ Bedrooms
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 supuly lines.
m
SOUTH
I hereby certify information submitted
as Sh pn.
Ow or Agent
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
nr Heating Permit
iR
Sewage Permit
-4
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
is correct and there are no other structures located on this property except
Date
7/,K77/
A LAND USE OR STRUCTURE PERMIT thtiliST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
)O NOT WRITE BELOW THIS LINE
Sewage Permit Number Issued _
Remarks
The zone is
t
Building �ermit %' /7/ReceiptkSr1 sued
Form 523 Bldg. Code