1972, 07-03 Permit App: J3630 Pool• r
County of Spokane Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99201
de) 0
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 mast conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
NATER. 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.
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
Name of Owner
Architect
Contractor, j
Legal Descriptio of ; roperty LGive
APPLICANT FILL 111 BELOW THIS LINE
ddress % l
one Engineer
Address
c;mplete description fr
Mr A 0114
deed, tax receipt, etc.)
02 e
Phone VJA1)-34 6
Phone ,/
Phone/40 -9-39`5-7
DESCRIPTION OF WORK: New 1` Addition
gize Lot ir (.(C ri}-f p1
(-'G '+ - Dimensions / 9 t'3S
Remodel
Moving
(Frame, concrete, brick, etc.)
Rooms "—Baths --- Basement -- Foundation Const
(Full, part, none)
Heat. System
Use of Bldg.
Garage or Carport Attached
Bld Zone 4-- Fire Zone .1
Sewage System Stories o
Total Sq. Ft. l to Valuation j59"
Type of oofing Ext finish
himney
(Kind)
Fireplace
(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.
NORTH
I hereertify informatio
as show
SOUTH
itted is correct and there are no other structures located on this property except
dor
m
Rio
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
Ow. .r Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
DO NOT WRITE BELOW THIS LIME
Your street address will be
Sewage Permit Number
Remarks
77. /2a
Issued Building Permit
The zone is
Receipt
Form 523 Blda. Coda