1973, 03-23 Permit App: K924 MH411 IP
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND 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 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
ddress ‹../9 �d-V----e:11-c0.--/ Phone rn-�-
Name of Owner
-
Architect Phone Engineer Phone
Contractor / Address .P i
Legal Decription
complete description from deed, -ax receipt,
DESCRIPTION OF WORK: New__ Addition Remodel Moving
Size o-ff/ Lot �' a i X / 2 SS 7 , C ' Sewage System
Cr sdlr/f�21 JZZic pp Dimensions /rQ ). /r 6 Total Sq. Ft
, coonf rete, brick, etc.)
h ?` Baths / Basement Foundation
Phone �Jct�y7 c x
etc.) / 9 /JO 6
B1
Rooms
Heat. Syste
Use of Bldg.
•
ull, part, none)
r.✓ T pe of Roofing
Const
g. Zone
Fire Zone
Stories Ct—rt._)P`..
��y v�
Valuation >5' -1/
Chimney —` Fireplace
Q _ (Kind) (Number)
„-ytpa� Ext Finisiv�� Int. Wall Finish,7e7--77_,e
No. of Units / Bedrooms
Garage or Carport Attached
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.
;_.-tPrivate Detatched (-
as
NORTH
34,�
Coo
—YY) c ,6 / e
31 1
SOUTH
Stat ense No.
Ind. Ins. ct. No.
REQUIRED
Plumbing Permit 6j i A
Heating Permit
D Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
hereby certify inf rmation submitted is correct and there are no other structures located on this property except
CJI - �,
,L
Owner or Agent
D$te
- 73
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number Issued Building Permit
Remarks
DO NOT WRITE BELOW THIS LINE
e zone 1s
ceipt 2 -Issued
Form 523 Bldg. Code