1972, 07-12 Permit App: J3726 Residence4,
•
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
kind or alter any building or structure already erected, or to change a land use. Construction mast conform with
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 tront 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
sale
Sym 6
Name of Owner �'___ �.iXe ddress /170-2/1 '/ Phone `s - L 4`' 3
Architect Phone Engineer Phone
Contractor Address Phone
Legal De ri on of Property (Give complete descr ion from deed, tax receipt, etc.) rs`- J.�
DESCRIPTION OF WORK: New Addition
c
Size of Lot
Dimensions
s-----
77 .f - Ff
e, oncrete, brick etc.)
oms Baths - ment Foun Const Chimney
fart, none) (Kind)
Ty of Roofin x[ Finish Int Wall Finish
No. of Units _ Bedrooms
Garage or or Carport Attached
Remodel Moving
Sewage System
Total Sq. Ft.
B1d raZone
Fire Zone
Stories z
Valuation S.7, -71 �S
Heat Syste
Use of Bldg.
Fireplace
(Number)
Private Detatched
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location ofrexisting and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH
I hereby certify information submitted is correct and there are
as shown.
m
D
.n
ti
State Licen No.
Ind. Ins. Acct. No.
REQUIREDUI
Plumbing PermiC fix` '---
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
no other structures located on this property except
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS 1S NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Date
CONSTRUCTION COMMENCES.
Your street address will be
Sewage Permit Number
Reser
/0/13----E
Toe one
Issued
Building Perm
Receipt
saved
Form 523 Bldg. Code