1971, 09-16 Permit App: J0715 Residencet_ -- 0 &
J c1 County of Spokane. Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99401
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS S�
PERMIT FEE...' ...............
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 -RACK 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 III BELOW THIS LINE 1_
Name of Ow r _% 1_ �i �C? �Iddreas
Architect .S�-=,q� /�-iGY f, Phone gineer
Contractor Address
Description of P l�
pe (Give
IAC' /•1- l_�t?�.Lt �
i
ription from deed, tax rete
-- e
Phone 1JC:!J ` e g_=�/
Phone
Phone
DESCRIPTIO14OF WO K: New Addition Remodel Moving B1d0. Zorle — Fire Zone
Sizer'f, CAP it % Sewage System AC IVStories a�
Const. Dimensions Jkss� C' k � Total Sq. Ft. �5 �(> Valuation c'
(Frame„'c ncrete, brick, etc.)��';”
Rooms � Baths Basement«' Foundation Const. Chimney Fireplace
(Full, part, none) (Kind) (Number)
Heat. Syst _Type of Roafin Ext. Finish 7- �// Int. Wall Finish
Use of Bldg.% 47� G No. of Units Bed ooms ;�
Garage or Carport Attached 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.
REQUIRE
Plumbing PennLt � y
in Heating Permit
DSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
'I he e'y ccertify nforma—t submit( is correct and there are no other structures located on this property except
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
[� DO NOT WRITE BELOW THIS LINE
Your street address will be o / Af )Q L f 1 e zone i
Sewage Permit Number Issued Building Permit Receipt Issued
Remarks