1971, 11-03 Permit App: J1209 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE. SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
POWIT 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 -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.
Name of Own
Architect
Contractor
a
P LICANT FILL IN BELOW THIS LINE
Ciaostousass Phone
s ddress
gineer
Address
Legal Description of Property (Give complete scription
— ia(93— g S
i
ffr deed, r,ceipt etc )al
• �i / ii
Phone
Phone
Phone
.%4
DESCRIPTION OF WORK: New Addition Remodel
Size of Lot 0001 a 1 4 A
Const. Dimensions
(Frame, trete, brick, et )
Rooms Baths eV� Basemen
(Full, part one)
Heat. System %i ' ' eTyp1 of Roofing
Use of Bldg. 11]]
Garage (x C..rpvrt Attached
Moving
o�� Sewage System
_
ll ,- �7 "'"7� Total Sq. Ft.
Ext Finish r//,
Foundation Const.
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.
Bldg Zon
Fire Zone
Storiess
Valuation ; qa 0
Chimney
Fireplace
(Kind) (Number)
Int. Wall Finish
No. of Units
Private Detatched
NORTH
r
k9
25`r
.
a
N
22
sip
t
T
%,
SOUTH
State License No.
Ind. Ihe: 1tcc\ No.
REQUI ED
Plumbing Penni
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
certify infory ion tted is correct and there are no other structures located on this property except',
Owner or Agent
Date
A LAND USE OR STRUCTURE PERMIT MU r BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NO a TE BELOW THIS LINE
Your street address will be
Sewage Permit Number
Remarks
as ued
Building Pe it
e zone is
Receipt 3�
Form 523 Bldg. Code