1972, 01-24 Permit App: J1717 ResidenceJ
County of Spokane, Washington
BUILDING CODES DEPARTMENT, CCURTMOUSE, 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 a07
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.
ISET-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
9
Name of Owner � ia_Address
Address
;
Architect
Contractor
ne Engineer
Address
(GiveProperty a complete description from deed, tax
13 - 3,,,o
r4.4 1 11
DESCRIPTION OF WORK: Ne L� Addition
Size of Lot Rea, Y 4 10,3
Const 4 /41.1t,
(Frame, concrete, brick, etc.) O
Rooms Baths A Basement Foundation Const. �1h
ay�y (Full, part, none)
Heat. System _TA Type of Roofing �� L4" Ext. Finish
inn _
receipt, etc.)
Phone
Phone
Phone
Remodel
Moving
Sewage System
Total Sq. Ft,
Dimensions T.
Bldg. Zone __._—�-- Fire Zone ,
T Stories 1
( Valuation �, 670
Chimney — Fireplace
(Kind) (Num;
Int. Wall Finish
Use of Bldg.
Garage or Carport Attached
No. of Units Bed ooms
Private Detatched
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 acrd streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
Gv/
m
NORTH
I her
as shown.
SOUTH
submitted is correct and there are no
other
No.
State Licen
�f�
Ind. Ins. Acct. No.
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
structures located on this property except
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
ft -0 DO NOT WRITE BELOW THIS LIME
Your street address will be __the zone is �!J
Sewage D (din Permit Receipt
r 0 Issued
g Permit Number Issued Bui g 7/ _ Re p
Remarks
l7
Form 523 Bldg. Code
/
tit, 0*
APPROVAL
3P� CO. HEALTH DIST,