1972, 08-14 Permit App: J4084 MHT
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 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 Owner,
Architect J
Contractor Lc2
Legal Descr'ptionnoff Proper (Give
Address Phone
'igineer one
,Ti'` s i : '.�i%t3"�- hone laa— V
p ion from deed,
d, tax receipt, etc.) '
P
omplete desc
DESCRIPTION OF WORK: New ' \ Addition
Size of Lot 1 ' o2 . a 9 x / / w- . b - X .
Const. Dimensions -22 2
(Frame, co ete, brick, etc.)
Rooms Baths � -Basemen Foundation
(Full, par one)j
Tempe oofing �y�-y2-�ex Ext Finish
Remodel Moving
}C 1 i'? .S] Sewage Systen
Total Sq. Ft
Const
Heat. Syste
Use of Bldg.
/ 3a
Bld.. Zone
Garage or Carport Attached
Fire Zone /
Stories�,ie
Valuatiorf-*% Z
mney Fireplace
(Kind)
�--••••t Int. Wall Fini
No. of Units Bedrooms
Private lletotched
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.
ttt
NORTH
I hereby
as shown.
ertify info
SOUTH
on submitted rect and there are
e
-.i
State License o.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
no other structures located on this property except
Owner or Agent Date
A LAN ' SE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THI NOT A PERMIT.
O^� 44r /73z/
Your street address will be
Sewage Permit Number Issued
Remarks
DO NOT WRITE BELOW IS LINE
G
.► / G/� _'he zone is / %;j
Building Permit 7 'O'Receipt
ssued
Form 523 Bldg. Code