1974, 03-27 Permit App: K4004 Pool/5
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County 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.
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 provisiohs of covenants or dedications and easeeents 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
- -_ ddresst�t.phone
Name of Owne
Architect
Phone FStgineer
5262 y-as.9g
�/ p� Phone
Contractor i7y z 2,/. ��-e.- Address Phone
Legal I -script ion of Property (Give complete description from deed, tax receipt, etc.)
/4 o2 5- .- Y/
DESCRIPTION OF WORK: New
Size o
C
Rooms
L
Addition Remodel
`>f•a
F, tonere
imensions / 5--
ick,
Sick, etc.)
Baths —Basement Foundation Const
(Full, part, none)
Heat. System Type of Roofing
Use of Bldg. n.tt-rn-Ylt_. �x ae
Garage or Carport Attached V/
Moving Bldg. Zone / Fire Zone' --/F-0----/F-0--)(-2Sewage System O -Q Stories
Total Sq Ft. .5--a),..1-k7 Valuation ,Is POO
/7
A/A- Ext. Finish -4//a
Chimney —Fireplace
(Kind) (Number)
Int. Wall Finish /1C/¢
No. of Units Bedrooms
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
NORTH
PLOT PLAN
property lines; (2) street or road locajiuns, j ''"' ''in ' C ,..:,,ting and
lines and streets; (5) -dimensions oildings; (6) location of sewage SYS-
Wgit
Ptivate Detached ^�
a°
I
as sho
e•eby ce
SOUTH
rft
informa " n submit/
.ifJ/, In _. /.
Owne or Agent -„mak
A LAND USE OR - ' UCTURE PERMIT MUST BE ON'THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
s corr
State License No.
c)rz23 -a/ -//3/V
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
..� m
Heating Permit
HSewage Permit
tib y
Plans Received
Plans Checked
Plans Returned Plans Picked Up
Plans Mailed
and there are no other structures located on this property except
Date
DO NOT WRITE BELOW THIS LINE
\AI,
Your street address will be
Sewage Permit Number Issued
Remarks
Building Permit
Re
e zone 1s fief ee--0 •
ceipt SS/ ssued
Form 523 Bldg. Code