1971, 11-03 Permit App: J1208 Residence•
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS
PERMIT FEE.:, j... -
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 onwater 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 47235.
SET -HACK 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 ddress '%' / %� ,may.•. one__~_, / g
Architect Phone gineer % Phone /
Contractor
Address Phone
Leg 1 Des ription of Pro rty ive complete description from deed, tax receipt, tc.)
DESCRIPTION OF WORK: New /ms Addition Remodel/ Moving Bldg. Zone Fire Zone
Size of Lill 1/ 4 `- / C V )�
Const 61c/si07"t . , Dimensions # y-'. �i - 0.3 - i 0
(Frame oncrete, brick etc.)
Rooms Baths Basement Foundation Const. lit/YL G�,..lo Chimney Fireplace
(Full, part, a (Kind) (Number)
Heat. System Type o Roofiig Ext. Finish T / / / Int. Wall Finish
Use of Bldg. Ott
No. of Units Bedroom
Garage e>e-Gmport Attached
Private Detatched
Sewage System 01.0eValuation
Total Sq. Ft. tF 4 Valuation O,, l (Q
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.
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State License No.
Ind&%Ae.r` No.
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
,Y .formatimitted is correct and there are no other structures located on this property except
//-3- 7/
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT . QST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
DO NOT . TE BE OW THIS LINE
ssued
Building 'erm
e zone
�-J/I,�Receipt
Form 523 Bldg. Code