1971, 05-18 Permit App: I4382 Addition•
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 9920
APPLICATION FOR LAND USE OR STRUCTURE PERMI Je2
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.
Name of Owne
Architect
Contractor
L .f1I Description of Pr
"iv ;
DES I.�
Size of Lot
APPLICANT FILL IN BELOW THIS LINE
i ��� ddress
Phone Engineer
Address
perty (Give comple e description from deed,
a+rtSa
/ 7 n 4
U
ax receipt, etc.)
_
•
Phone
-C(7 3
Phone
ION OF WOR : New
a x /en)
Addition
Remodel
Moving /
Const Dimensions
(Frame, concrete, brick/etc.) / 14 , _ _ D�
om -Baths Basement Foundation
/DD, (Full, part, none) er y§te Type of Roofin
Use of Bldg.rn:s'_ --C
arage or Carport Attache
3 S
m
to
Sewage System '
Total Sq. Ft
Const ( '
Ext Finish
Fire Zone
Stories
Valuation
G
Chimney Fireplace
(Kind) (Number)
Int. Wall Finish •1--e.S2_,
No. of Units Bedrooms .
PLOT PLAN
Private Detatched
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of ex
posed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of
m and water supply lines.
4111771111111111
sting and
ge sys-
NORTH
SOUTH
� J
I hereby cer 'fy information submitted is correct and there are
as shown. =d`
__.)._
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
no other structures
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
located •n thi property except
Your street address will be
Sewage Permit Number Issued
Remarks
DO NOT WRITE BELOW_THIS LINE
Buildg Permit
y3
e zone is
Receipt,rafe
Form 523 Bldg. Code