1972, 01-25 Permit App: J1720 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99501
APPLICATION FOR LAND USE OR STRUCTURE PERMIT J� G�
GENERAL REQUIREMENTS PERMIT FEE
PERMMIT REQUIRED. A land use or structure permit is required by Cotwty 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. 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.
SF'" -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property line, of at
1e�st 25' is required, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yard are required.
STTE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
an 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 IFI BELOW THIS LIFE f;60
Name of Owner tt%#'- lfil z
` c__Address ddress �� ' X Phone l�U -G -
Architect M C 1 Phone Engineer Phone
Contractor Address Phone
Legal Diescript on*lof Property (Give c mplete description from deed, tax receipt, etc.)
DESCRIPTION OF WORK: New / AddmMo
ition Reodel vin 1 Bldg. Zone Fire Zone �`
Size of Lot Rt, fjX / Q Sewage System .ST. Stories / �'-
Const Ff,1 i Dimensions/Z'S--A-_56. Total Sq. Ft. 13 6 d Valuation � 2 6 C)
(Frame, concrete, brick, etc.) -.-t'",-C4.---1 Rooms 3 _ Baths . Basement Foundation Const L n'jr� Chimney Fireplace
(Full, part, none) (Kind) (Numj�er)
Heat. Systeme/� 7
_ Type of Roofing 6.y a -2 Ext Finish /72 AS%)✓1 16 Int. Wall Finish n ' 6 1
Use of Bldg. -12.4.// No. of Units Bed oms
Garage or Carport Attached 'tel
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 streets; 5 dimensions —_f.uildi..., . (a) location of sewage sys-
tem and water supply lines.
NORTH
State Licen a No.
Ind. Ins. Acct. No.
Plumbing Permit
m Heating Permit
VP Sewage Permit
iu+
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.
Owner or Age
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
DO NOT WRITE BELOW THIS LINE
Issued
Building Perm
e zone is
_ Receipt
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Form 523 Bldo. Codas
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