1972, 05-15 Permit App: J3117 MHa L
County of Spokane, Washington
DING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401
AI'PLICATI®N FOR LAN® llSE OR STRUCTURE PERMITmol
GENERAL REQUIREMENTS PERMIT FEE____41
__----------
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 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.
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 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 BELWj W THIS LINE `
Name of Owner
Architect
Contractor
Legal Description of I
S
Phone Engineer
Address
(Give complete description from deed
tax -recent, etc. )
PhWe
Phone
Phone
DESCRIPTION OF WORK: New. 1- Addition. Remodel. Moving Bldg. Zone L� Fire Zone
Size of Lot Sewage Syste ' Stories
Const. Dimensions ��l Total Sq. Ft. / 0
( Valuat
io
(Frame, concrete, brick, etc.)
Rooms_ Baths Basement Foundation Const. Chimney Fireplace
�j (Full, part, none) (Kind) (Number)
Heat. System _ Type of Roofing Ext. Finish Int. Wall Finish
Use of Bldg. r�C4.Z
Garage or Carport Attached
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.
NORTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
M Heating Permit
NSewage 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. / / -79
t
5
v Owner or Agent Date '
A LAND USE OR STRUCTUR PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOTCRUIT.
"Y YIGV� DO NOT WRITE BELOW THIS LINE
Your street address will be S 1 e zone is
Sewage Permit Number Issued Building Per i Receipt 9 Issued
4
Remarks
Form 523 Bldg. Code