1971, 01-24 Permit App: J1704 ResidenceCounty 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 Cotunty Resolution to erect a building or structure of an.
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.
cliEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 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
east 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 LIFE
Name of Owner
Architect
Contractor
Legal, Description of Pr
ddress
Phone Engineer
Phone
Phone
Address Phone
perty (Give complete description from deed, tax receipt, etc.)
DESCRIPTIONOF WORK:��New Addition
Size of Lot g�R K las
Const. Dimensions 3 q4 as
ram concrete, bric3, etc.)
--SRooms � _ Baths B: Bement
part, none)
Heat. System 1 6 Type of Roofing
Use of Bldg. 0/4- x
Remodel
Moving
Foundation Const
�!►l
Bldg. Zone Fire Zone
Sewage System 1 Stories 1,,,�, l
Total Sq. Ft. q 7 Valuation J R vV V /
Chimney Fireplace
(Kind) (Nu 'ber)
Ext Finish A(014 1/ Int. Wall Finish 11 ✓,'.4 ' /
No. of Units Bedrooms _
Private Detatched
Garage or Carport Attached
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.
4/1
NORTH
SOUTH
State L No.
Ind. Ins. Acct. No.
REQUIRED
9 f `
11.. /I�
/
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I 1lereby ce tify •for :+ion submitted is correct and there are no of er s ructures located on this property except
as shown. /
Owner o./ Agent Date
A LAND USE OR STRUC URE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
1 /L�✓ �r .. '
Your street address will be
Sewage Permit Number
Remarks
DO NOT WRITE BELOW THIS LINE
Issued
Build
ng Perini
__the zone is ,t
t / Receipt i' & C Issued
Form 523 Bldg. Code
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