1973, 05-03 Permit App: K1543 MH0 An,
0
County ®f Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401
APPLICATION FOR LAN® USE OR STRUCTURE PERMIT i
GENERAL REQUIREMENT S PERMIT FEE ------- J__ �_...__._..
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 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 BELOW THIS LINE
Name of Owner
Architect
Contractor
Legal Description of
G.G7i •T
Phone
(Give c
_Engineer
Address _
iptLon from
receipt,,,etc.)
Phone
Phone
Phone
DESCRIPTION OF WORK: New. Addition. Remodel. Moving Bld Zone Fire Zone 3
Size of Lot 7k)"'! A20 Sewage System P _Stories
Const. Dimensions 42;x%,9 Total Sq. Ft. LJ✓� Valuation ��04
(Frame, concrete, brick, etc.)
Rooms '5 Baths Basement Foundation Const. /DC"� Chimney Fireplace
'! (Full, part, none) (Kind) (Number)
Heat. System �' e—. Type of Roofing P" xt. Finish d Int. Wall Finish
Use of Bldg. _
No. of Units Bedrooms
GarJgeoarport Attached Private Detatched.
iPLOT PLAN
etch with dimensions showing: (1) property lines; (2).street or road locations;
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings;
tem and water supply lines.
NORTH
�y
f /oxss
3l
(3) location of existing and
(6) location of sewage sys-
State License No.
r --
Ind. Ins. Acct. No.
REQUIRE
Plumbing Permit
Heating Permit
Sewage Permit
Plans Receive
Plans Checke
Plans Returns
Plans Picked
Plans Mailed
SOUTH
I hereby ce ormation submi is correct and there are no other structures located on this property except
as shown.
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT M ST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT II PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be f 7"/ to a / The zone is
Sewage Permit Number Issued Building Permit S" Receipt Issued
Form 523 Bldg.