1971, 10-08 Permit App: J0936 Addition111
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 9920
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.
NATER. Mater 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.
NIMPFINW1'
APPLICANT FILL IN BELOW THIS LINE
Name of Owner
Architect Engineer Phone
Contractor Address Phone
Legal Descript,ion f Property (Give Somplete descr ption from deed, tax receipt, etc. IP,,,Lan., /�- S/ --Za4,
—_w, Arlo Z . /64 ' N. ISS x3A, i(: /1,9 _
( .E.ENy4CRZs JRR./ DIST, PLA7A.
ddress
O/6
one yl A
Phone
DESCRIPTION OF WORK: Nev� Addition Ii Remodel Moving Bldg. Zone / Fire Zone
Size of,gt / %jQ i( /� Q Sewage System Stories / D
Const.. �,Q�.ttL Dimensions /D )'J.41) Total Sq. Ft. %�� Valuation �Oa
(Frame, concrete, brick, etc.)
Rooms -- Baths — Basement
Heat. System
Use of Bldg.
Foundation
(Full, part, none) �,,�
Type of Roofit�ig✓" `
Const
Chimney Fireplace
�� (Kind) (Number)
Ext Finish _a.L�+%t.vv"y/ Int. Wall Finish '--`
Garage or Carport Attached
tit
No. of Units Bedrooms
Private Detatched
PLOT PLAN
aw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
sed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
and water supply lines.
NORTH
Mt55/ 1j/
I here certify informat
as show
SOUTH
1
D
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked V
Plans Returned
Plans Picked Up
Plans Mailed
mitted is c. rect and there are no other structures located on this property except
4
Owner or gent
A LAND USE OR STRUCTURE PERMI
THIS IS NOT A PERMIT.
g
Date
UST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW T
Your street address will be -h
Sewage Permit Number Issued
Remarks
S LINE
Building Permit
e zone 1
0 3(, Receipt l//_ C% Issued
Form 523 Bldg. Code