1971, 06-28 Permit App: J0012 Addition$ •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
00
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 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 1s 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 Owner
APPLICANT FILL IN BELOW THIS LINE
ddress
gzo6
Phone WA & L/ `-L .e 7
Phone
gineer
Phone
ddr'ess3- /v Phone 64.14
tM� 4 —7 tt
/7017.'1 - /607
Contractor
Legal Description of Property
ko? 6 QA.K
(Give cpmp Le description deed, tax receipt,
etc.
•
DESCRIPTION OF WORK: New
Size of Lit), 7 -3 X 3/!J
Const. Dimensions
Addition <- Remodel Moving Bldgo Zone Fire Zone 1? � ',
Sewage System Stories
Total Sq Ft. "Pi Valuation b DOD —
/i/ X3.'
(Frame, concrete, brick, etc.) /i -�
Rooms A Baths _Cr Basement "'-- Foundation Const. L_F-��f�CirLl/1 ? i Chimney Fireplace
(Full, part, none) -- (Kind) n (N her)
Heat. System// Typ of Rqofing lam'✓ / Ext. Finish Int Wall Finish
Use of Bldg. ,-Pttharei Q Q.(,Gt---x-rt. —�j .�pc —Air No. of Units Bedrooms
Private Detatched
Garage or Carport Attached
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
I her cp•r'info
as shown.
SOUTH
ubmitted
correct and there ere
Owner o Agent
A LAND USE OR STRU URE PERM
THIS IS NOT A PERMIT.
State _License No.
AXP
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
no other structures located on this property except
6—.22-7/
Date
MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE
Your street address will be
/D 17
Sewage Permit Number Issued
Building Permit
RI
e zone is
Gu/2-Receipt-I,76 sued g-7/
Remarks
Form 523 Bldg. Code