1971, 08-23 Permit App: J0841 DuplexNIL IS
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 mast conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
wMYE6.4fter 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.
SEW,i3E SYSTEM. Permits are required in all cases by County Resolutions N. 45-133 and 47235.
SEF -SACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property line, of at
least? 25' is ?equiree, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yardre r*quired.
STAT HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and
and egress.
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work
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.
ingress
must be
APPLICANT FILL IN BELOW THIS LINE
Name of Owner
toy..4---/C, `j Z
_ _ --- ddress-d / 0e).3 - Phonei%n
Architect Phor Engineer Q '✓/u -G !/�/� Phone 2�'�"�SS ;/
Contractor Address t�
Phone
tax receipt, etc.)
Legal Desc 'ption of P erty ( ive omple descriptio from deed,
DESCRIPTIOI/] OF WORK: New)_ Addition
Size of Lot // y -v 7 7
Const Dimensions
(Frame, cc,iperete, brick, etc.)
Rooms b Batbs 4 Basement Fou
F 11, part, none)
Heat. Syst!t(i fi24=4.� Type of Roofin
Use of Bldg.
Gavage orCurport Atttitliad
Remodel
Moving Bldg. Zone / Fire Zone
Sewage System Stories
Total Sq. Ft. 2- / 2 0
ion Const
Valuation
Chimney Fireplace
/7 (Kind) (Number) /Jv
Ext Finish) -' Int. Wall Finish -e —e
No. of Units Beds
Private Detatched
PLOT PLAN
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 bujldings; (6) location of sewage sys-
tem and water supply lines.
�GU
H
NORTH
-c4e_
cL
' I hereb
asishown. i
State License .
a3 -o(-
Ind. Ins. Acct. No.
REQU RED//
Plumbing Permit ��'+��
• Heating Permit
N Sewage Permit
-1
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
certify information submitted is correct and there are no other structures located on this property except
Owner or Agtnt Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CON
THIS IS NOT A PERMIT.
094 fir, z
Your street address will be
Sewage Permit Number
Remarks
0
DO NOT WRITE BEL
0
THIS LINE
Issued
Building ,• 'rmit
TRUCTION COMMENCES.
e zone 1s
ceipt
Issued
Form 523 Bldg. Code
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