1972, 05-12 Permit App: J2989 Pool• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT r�I a `�
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 most 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 onwater 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. 45-133and47.235.
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
Name of Owner _ i� / -✓ deddress g
Architect P e gineer
Contractor /-�!'� Address
6
Phone 2/ 0707
Phone
Pr one
Legal Description Property (Give mplete de cription from deed, tax receipt, etc.)
DESCRIPTION OF WORK: New x Addition
Size of Lot
Const.
(Frame, ncre , brick, etc.)
Rooms Baths Basement
(Full, part, none)
Heat. System_ Type of Roo it Ext. Finish
Use of Bldg.
/
Dimensions ensions/ R ,( 3 { /]
Chimney
Remodel Moving Bid.. Zone
Sewage System --
Total Sq Ft f` t
Fire Zone
uationW,S J'O 0,
Foundation Const
Garage or C urport Attached
Fireplace
(Kind) (Number)
Int. Wall Finish
No of Units Bedrooms
Priv:de 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.
J NORTH
rn
rn
N
SOUTH
I hereby certify nforms i on ubmlt, ed is correct and there are
as shown.
•Owner or Agent
State Lice a No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating -Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
no other structures located, -on this property except
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 bee / 2 0 i_ 7ia�F012_e-jC The zone is
Sewage Permit Number Issued Building Permit �teceipt %�
Remarks Y
1
Issued
Form 523 Bldg. Code