1971, 10-12 Permit App: J0987 MHCounty of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE. S7OKAPIE. WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE. PERMIT J
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by Ccunty 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 most 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 NCA. 45-13.3 rind 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.
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 he 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 BEL • W IS
Name of Owne
Architect Phone Engineer Phone
Contractor �y�l�— Address Phone
ddress / — _ 11 .R..1 / Phone %
Legal Description of Property (Gi
complete description +rom deed, tax
DESCRIPTION OF W 3{: New Addition
Si : of Lot ' X 13/0
nvensions
conte, bri k tc. )
Rooms 5 Baths Basemen
(Full, p ,none)
Heat. System ( Type of Roofing Ext Finiiss i
Use of Bld\_ /!(A� C 2�1/: i �/
Garage or Carport Attached
Remodel
Moving
Sewage Syste
Total Sq. Ft.
Bld
Zone
Fire Zone 1/43
Sties /
Valuafign 6 1!(
Foundation Const Chimney Fireplace
(Kind) (Number)
Int. Wall Finish
sA4� ry No. of Units Bedrooms
Private Detatched
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or rod 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
-1
NORTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify ;'formation submitted corrg' and there are no other structures located on this property except
as shown.
ner o gent
/6-/L 7/
Date
A LAND USE OR STRUC URE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit )Fymber
Remarks
DON T RI BELOWf TP4IS win
Issued
7
Building Perm;.
'l'e zone i
Receipt 7
Issued