1972, 08-28 Permit App: J4181 PoolCounty 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.
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.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner C 0NR ACI
ddress r17 y . 6le Ju, 6,4•E4 L Phoneftjf4 V -/ Y7 2
Architect Phone ' Engineer
Contractor •y r Address
DESCRIPTION OF WORK: New Addition
Remodel
Phone
Phone
Moving Bldg. Zone / Fire Zone 3'
Le 1/,i:scription of .pror rty ive complete description from deed tax receipt, etc.)
Size of Lot / U d `k I) -d r Sewage System Stories
Const. / Dimensions ` w 3 c / _Total Sq. Ft 5 74 Valuation
(Frame, cor rete, brick, etc.) �/ �/�..'1 .
Rooms Baths Basement Foundation Const
(Full, part, none)
Heat. SysteType of Roofing v Ext Finish
Use of Bldg. �Q�.0-• --� i.
Garage or Carport Attached
rt„, -
Chimney Fireplace
(Kind) (Number)
Int. Wall Finish
No. of Units Bedrooms
Private Det•itched
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-
em
m and water supply lines.
i�
m
t
NORTH
I her certify formation
as show ` v 1 .
Owner or Agent
itted is co rect a
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
there are no other structures located on th's proper except
z_ -
Date Date
A LAND USE OR STRUCTURE PERMIT MUST BE 0 T E 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 i
Receipt
Issued
Form 523 Bldg. Code