1971, 04-05 Permit App: I3910 Pool0
County 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 byCounty Resolution to erect a building or
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 onwater 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.
structure of any
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.
n ,I y� APPLICANT FILL IN BELOW THIS LINE /� /7
Name of Owner P2 Ami gee S C". Address t yLj U y l-L�.(.A KP Phone
Architect Phone ginee/r En/Phone
/
Contractor &1 l-0 62V --c--& .µG Address)/). 70 /-a-�i++�i, JE l Phone Ai, 9.? .CJ
Legal Description f Property (Give complete description from deed,..�ctax receipt, etc.)
/v /10 ' vi [C) ge •� ♦ L0. e- a / / ctA 4. 4 e
DESCRIPTION OF WORK: New Addition O
Size of Lot 36' X /10'
Const.Cfr11P + 4flNy/Dimensions / 1' )('32
(Frame, concrete, trick, etc.)
Rooms
Baths
Remodel
Moving Bldg. Zone
SewaSystem Stories
Total Sq Ft .J 1.2 Valuation 4' /.d G
,/J 7 6-0
Basement Foundation Const
(Full, part, none)
Type of RoC-Ve
Garage or Carport Attached
Heat System
Use of Bldg.
/
Fire Zone .
Chimney
Ext. Finish
Fireplace
(Kind) (Number)
Int Wall Finish
No of Units Bedrooms
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.
SOUTH
I hereby certify information submitted is correct and there
Li
Owner r Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOTA PERMIT.
as shown.
c�1cn-c_
rn
in
N
N
State License No.
Ind. Ins. Acct. No.
Plumbing Pe
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
are no other structures located on this property except
4/s
Your street address will be
DO NOT
W BELOW THIS LINE
_ e zone is
Sewage Permit Number Issued Building Permit" 3 y/,-) Receipt
ued
Remarks
Form 523 Bldg. Code