1972, 01-25 Permit App: J1719 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT YGENERAL 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 pork 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.
TATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
ILO
egress.
OUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
rformed 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 111 BELOW THIS LIN
Name of Owner Address
ArchitectPhone Engineer Phone
�A %�l i
Contractor Address Phone
of Property (Give complete description from deed, tax
DESCRIPTION OF WORK: New V Addition
Size of Lot go h 1 ;--<- 73-
%� X
Const /Cil,/1'1 Dimensions
(Frame, concrete, brick etc.)
Remodel
Moving Bldg. Zone
Sewage System S' 7
Total Sq. Ft. 1, ? (J
Fire Zone
Stories /��
Valuation c2
Rooms -S _ Baths J \ Basement Foundation Const. (.�71.. Chimney Fireplace
ul part, none) / ^n i (Kind) (Num�� r)
Heat. System FA Type of Roofing C _ A/�� Ext Finish ,I I S 1" �� Int. Wall Finish �-
Use of Bldg. 2.‘21..4i
Garage or Carport Attached
No. of Units B
Private Detatched
ooms
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.
td
NORTH
Stote_”0, No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
n� Heating Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown. -
1/*/)('
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
'71
DO NOT WRITE BELOW THIS LINE
Your street address will be <; 0 3 N. G4(1/ I n Zd
Sewage Permit Number Issued Building Permit
Remarks
The zone is
Receipt
Issued
Form 523 Bldg. Code
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