1974, 06-28 Permit App: K5098 Pool•
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE V
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.
or dedications and easements running with the land
bring action to enforc, covenants or dedications.
RESTRICTIVE COVENANTS. Builders should check provisions of covenants
which are enforceable through civil action. County Officials can not
Name of Owner
Architect
Contracto
Leg Description of Pr
APPLICANT FILL IN BELOW THIS LINE
- Address
Phone Engineer
(Tv Address
(Give
(Give complete description from ea,
3 -_ r=
I 2 -
x receipt, etc.)
Phone Z b L
Phone
Phone gT_?TJf f
DESCRIPTION OF ORK: New Addition Remodel
Size of Lot
Const _ Dimensions
(Frame, co trete, brick, etc.) ¢-
Rooms Baths Basement Foundation Const ILIAC 0 0 p Chimney Fireplace
/ U j ,Gf o (
/ 1-3G
Moving Bldg. Zone / Fire Zones
Sewage System Stories
Total Sq. Ft G �1 Valuation �J % �v �
(Full, part, none)
Heat. System / Type of Roofing
Use ofBld IP° A-. _Jw-
401 0.1 No. of Units Bedrooms
Garage or Carport Attached
(Kind) (Number)
Ext Finish Int. Wall Finish
Private Detatched
PLOT PLAN
Draw sketch with dim ons 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-
teyand water supply lines.
NORTH
j Ci
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify information submitted is correct and there are no other structures located on this property except
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WA.ITE BEA W THIS LINE
AO.
►..r���) % �L .e zone is
OltiiIring Permit 1-54 0 (( Receipt - .4 4 Issued
Your street address will be -_3
Sewage Permit Number Issued
Remarks
Form 523 Bldg. Code