1972, 02-14 Permit App: J1868 Residence• •
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 most 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 -RACK 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 moyed 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 naming with the land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
Architect Phone Engineer U�-
i� Phone u/ A-6-1•• a
Hama of Owner ddress /
Phone
Contractor .544,4,44..544,4,4.544,4,44.k_ Address /J Phone
Legal Description of Property (GiPe S,ompletm dee ri ti9n from deed, tax receipt, etc.)�{",d.�J�#0-5.4-7- �g0�
_Jr/77r a - /�3/ A' / d G 41xj.a-74-, '-
APPLICANT FILL IN BELOW THIS LINE
cO(o
DESCRIPTION OF WORK: New V Addition Remodel Moving Bldg.
Size of pit /44,1-4 Q.20 / • Sewage System
Const ih Cri Dimensions 2 =%X _ -P x,-C-3/Total Sq. Ft.
7 7
(Frame. concrete,//brick) etc.) �J �q
Rooms b Baths /J Basemetrat Foundation Const
(Full, part, none)
Heat. System • /' .�-} Type of ttogfing
0
Use of Bldg. AA , e t4�ys.•!J�/_I
i.e..
one Fire Zone
Stories % {
Valuation 3c5: 9Od au
Fireplace a
Garage or Carport Attached
i
f / Bedrooms
,(,ftl�4271_, No. of Units
dr
Chimney
(Kind)
�/9 t (Num ea r) L Q
Ext. Finish X - 907�ja4+ Int. Wall Finish U /IL,�-P•Y%1/
PLOT PLAN
Pnvute Detatched
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.
T
to
ti
NORTH
c g —_
_31(1
/lAAI PLiOUTH
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked _
Plans Returned
Plans Picked Up
Plans Mailed
her certify i•formatinn submitted is correct and there are no other structures located on this
Owner n• Aeont Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS ISNOT A PERMIT.
(
Your street address will ho / 00 /a _C_,_l-Ldht4 AN _RD Tho 9nne is
Sewage Permit Number refined ___ Building Perm,a Reenipt B69 % Issued
Remarks
property except
DO NOT WRITE BELOW THIS LINE
Form 523 Bldg. Code