1974, 06-19 Permit App: K4998 ResidenceIP •
County of Spokane, Washington
BUILDING ' CODES DEPARTMENT, N. $11 JEFFERSON, 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.
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 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
Name of Owner
Architect / Address
Engineer Address
Contractor Address
ress
eLegal Description of Property Give c
/72 of '
2
ription frpm ed, tax receipt etc
el-/ 4 2�S
Phone
Phone
Phone
/9 --
DESCRIPTION OF WORK: ew Addition Remodel
Size of Lot
Stories Dimensyons
Rooms / Baths
�js a
its em
Use of Bldg.
� ('
Moving
Sewage System
sement Foundation
art, none)
Type 9f Roofing
Bld
one
Total Sq. Ft
Const. Chimney
Ext. Finish
Draw sketch with
proposed buildings;
tem and water supply
/ I
m
a
PLOT PLAN
Fire Zone --7'
t.
Valuation / 6;
Fire ce
(Kind) //I (Number
Int. WaII Finish
No. of Units _ Bedroo$ Is
dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
(4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
lines.
NORTH
S /
1
1G
0
SOUTH
I hereby certif : mon submitted
Owner or Agent
is correct
m
a
State License o.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
i
and the are no other structures located on this property except
-(
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
DO NOT WRITE
/ 2
Issued'
Date
PREMISES BEFORE CONSTRUCTION COMMENCES.
LOW THIS LINE
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Build
The zone 18 . C< r> t'
ermit ��Rece ipt
ssued
ATL
Form 523 Bldg. Code
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