1972, 09-20 Permit App: J4478 MHCounty of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAPID USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE.._��•�
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 au 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 euf coven or
dedications.
APPLICANT FILL IN BELOW THIS LINE u 9,PGa�
�- — Phone IC
Phone !!
Name of Owne
Architect
Contractor / \ Address
Legal escr' tion/off Property (Give comp et ' e eript ion fro d ed,ii8a receipt, etc. )
a tP�4 2272Y5 i 04/
r
DESCRIPTION OF WORK: New ✓ Addition
Size o of CV//zr
Const. Dimensions
(Frame,] ncrete, rick, etc.)
Remodel
/-�cs7','t-A<J
Moving
Sewage Syste
Total Sq Ft
BL,.. Zone
Rooms Baths / Basement Foundation Const
/ (Full, part, 0.
Heat. System / �pe 4Q( Roofing / Ext Finish`
Use of Bldg. � �f.LU2n J t"1.Q! itrti✓1Q,4,,( �Ip1(
Fire Zone
toSjes 7
Valuation ?SOV
Chimney Fireplace
(Kind) (Number)
Int. Wall Finish
Garage or Carport Attached
No of Units _ Bedrooms `) _
Pnvate 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
SOUTH
I hertgyilcertify2.'.rmation subt li
as shown.
Owner or Agent
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
rrect and there are no other structures located on this property except
9- —zL-
Date
A LAN USE OR STRUCTURE PERM,% MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMI
Your street address w111 be
Sewage Permit Number Issue.
Remarks
I167 WRITE BELOW THIS LINE
1FP,„ imp.
Building Perm
e zone is
Receipt
ssued
Form 523 Bldg. Code