1972, 01-25 Permit App: J1715 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE. SPOKANE. WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 1
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land tse 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. Stater 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.
4EWAGE SYSTEM. Permits are required in all cases by County Resolutions Noe. 45-133 and 47.235.
eT -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property line, of at
ast 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' = _ ddress ?/'-6-4t-4La Phone /` ! U - 17/.2-6 40
if
Architect Phone Engineer Phone
Contractor. Address Phone
Legal emscripti n of Property (Give om ete description from deed, tax receipt, etc.) 3 3
/ 445- 41,2 — 3 3 0 �
DESCRIPTION OF WORK: New / Addition Remodel Moving Bldg Zone _` Fire Zone
Sewage Systema L -4 Stories
Total Sq. Ft. /��� ' O Valuation ///? ‘14 0
Fireplace
(Kind) (Number)
Ext Finish nt Wall Finish
No. of Units Bed oms
Size of Lot
co )( /3-s
Const Dimensions
(Frame, co crete, bric , etc.)
Rooms Baths •ment Foundation Const
part, none)
Heat. Syste � = • i� Type of Roofing
Use of Bldg.
Chimney
Garage or Carport Attached
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 and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
m
Q
NORTH
I hereby cert
State Lice se No.
Ind. Ins. Acct. No.
REQUIRED
i
.� '
Plumbing Permit -
rw Heating Permit u
a
Sewage Permit
-4
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
1 info t'.� .ubmitt is correct and there are no other structures located on this property except
Owner or Agent
Date
A LAND USE OR STRUCTURE PER IT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS INE
Your street address will be -' / '-
Sewage Permit Number Issued Building Permit , S Receipt �O
Remarks
e zone is
Issued
Form 523 Bldg. Cods
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