1972, 04-11 Permit App: J2600 MH• - •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201 o
APPLICATION FOR LAND USE OR STRUCTURE PER II
GENERAL REQUIREMENTS PERMIT F
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a buildin4 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..OINES. In most zones and under most circumstances, a set -back from the front aoperty 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 Address Phone /��
Legal escription o- Property Give co co�let�J' desc�r iiption from deed, tax receipt, etc.),�L�.3 ,5c _41d
.lig "'v+ =t._� //'Ca -o / / r.--4 ,r -P— O % J ,127-;:,/�� 3
APPLICANT F1 L IN BELOW THIS LINE
Q
ram saie
Phone
a
?20, 9
g ineer
Phone'7t 2 G �/
Phone
DESCRIPTION OF WORK: New X Addition Remodel Moving B
Sewage Syste
Total Sq Ft
Size of Lot //o X FriZ2- --
Dimensions /0 TV
nerete, brick, etc.)
Baths
Heat. Systeniyytt
Use of Bldg.
Zon
Basement Foundation Cons
11, part, none)
Type of Roofing
Fire Zone S
t$�les
valuatig 7-2-o v
himney Fireplace
(Kind) .64.12.4mber)
Int Wall Finish
No. of Units Bedrooms
Private Detatched
Garage or Carport Attached
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.
State tic a No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
w. Heating Permit
NSewage Permit
M
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby ertify information suitted is correct and there are no other structures located on this property except
as shown.
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 15 NOT A PERMIT,
DO NOT WRITE BELOW TIS LINE
Your street address will be
Sewage Permit Number Issued
Remarks " ti'
e zone 111 L-./ i
Building Perpit'\ Receipt
ssued
Form 523 Bldg. Code