1972, 01-04 Permit App: J1605 Residence9
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 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 cork on nater 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 dedicat tons 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
Name of Owner
Architect
Contractor
// - /
ddress o // e -
Phone Engineer
Address
5—te�
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
r...0e0=e c99 6 y/ — n 3 e --is
Phone %'e- 5 7/,
Phone
Phone
DESCRIPTION OF WORK: New
Size of Lot 7o X / 7 o
Cols Dimensions
oncrete, brick, etc.)
Rooms Baths - ent
B
(Ful hart, none)
Heat. System! &c /%3JType of Roofin
Use of Bldg. /.r�� -�P "--
Garage or Carport Attached
x Addition
Remodel Moving Bldg Zone
Sewage System
6,1' 3 6 8 2.41/± .6 -C Total Sq. Ft. /S / Z
Foundation Const
Chimney
Fire Zone /
Stories
3
Valuation 2// 0 0 0
Fireplace
(Kind) (Number
Ext Finish T— / — /(/ Int Wall Finish -
No. of Units - Bedrooms 3
Private Detatched
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or
proposed buildings; (4) distance to property lines and streets; (5) dimens
tem and water supply lines.
W NORTH
41°
G/m
1
30
7 C. —3
SOUTH
I hereby certify information submitted
as shown,
is correct and
road locations; (3) location of existing and
nus of buildings; (6) location of sewage sys-
State Lice se No.
Ind. Ins. Acct. No.
there are no other
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
structures located on this property except
OwnerC6r Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
OA.) 74,ta DO NOT WRITE BELOW THIS LINE
Your street address will be
Sewage Permit Number
Remarks
['sued
Building Permit
P �wv
e zone is
t1 65 Receipt slued
Form 523 Bldg. Code