1972, 09-21 Permit App: J4514 Remodel• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT o 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 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
Address 1®W= (_.
Name of Owner
Architect
aro .gf
Contractor
Legal Desctiption
Svv4
Phone
Address
Phone
Engineer
J +.,a. yu. Phone
Property (Give f completeiscription from deed, t r eipt,
99 a4 Phone R/-7-4s9�'
etc.),TQi#aasst•-07.2-5
DESCRIPTION OF WORK: New Addition
Size o y 7 5 'X /.S0
ConsLkT.�Q/,14.L- Dimensions -36 )63-r"�
(Frame, concrete, brick, etc.)
Rooms — Baths BasementP Foundation Const.
(Full, part, none) ��ff c,�
Heat. System Type of Roofing e. 3 4
Use of Bldg.
Remodel 1�
Moving Bldg. Zone
Sewage System e4,ut Z -i Stories /
Total Sq. Ft. /6 d1 t Valuation .T DUB
Fire Zone -5
Ext. Finish
Chimney Fireplaces �
(Kind) . (Number)
Int. Wall Finish
No. of Units Bedrooms
Garage or Carport Attached
Private 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.
NORTH
k2'�F."""'`'` ,
REQUIRED
Plumbing Permit
m Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I herertify information ubmitt}s correct and there are no other structures located on this property except
as shown.
/Owne or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES
THIS IS NOT A PERMIT.
Date
BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE
Your street address will be / 6 g0 S C�
Sewage Permit Number Issued
Building Permit
The zone i
z/ S76Receipt q6 9-n Issued
Remarks ;!
Form 523 Bldg. Code