1972, 07-05 Pemrit App: J0005 MH•
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.
NATER. 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 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 (j� / �A'
Name of Owner ' f�..v - h Address S `� 'J ,� " phone �j� d
Architect Phone Engineer Phone
Address Phone
Contractor
Le al Des iptio f Property (Give complete description from deed,
644- CPcve-i.
DESCRIPTION OF WOR K: New ' _ Addition
Size of Lot U 1
�u ��
Const. c- (%yt, 2dM Dimensions
(Frame, concrete, brig, etc.)
RBoms r/ Baths / Basement Foundation Const
(Full, part, none)
Moving B1:17Zone
eat. System
Use of Bldg.
Type of Roofing
Sewage System<)' Stories
Total Sq.'t .5-49 ' Valuation
Chimney Fireplace
(Kind)
(Number)
Ext Finish Int. Wall Finish
G
PLOT PLAN
Dr
w sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
pro ed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
and water supply lines.
No. of Units Bedrooms
Private Detatched
o'U
NORTH
I hereby
as shown.
c-rtify
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
tol Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
formation submitted is correct and there are no other structures located on this property except
er or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRIT - ELOW THIS LINE
Your street address will beC67- � � �fd�i �� ,1'he zone is
Sewage Permit Number Issued Building Permit 6 Receipt Issued
Remarks
Form 523 Bldg. Code
010.3,21
68
WEST VALLEY EXCAVATING
S. 812 DISHMAN ROAD.
WA.4-5130