1972, 10-04 Permit App: J4627 GarageCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT dr
GENERAL REQUIREMENTS PERMIT FEL ._/_ $
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.
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 BEL
Name of Owner
Architect
Contractor Z
Legal
rip ion of Prope
Address
hone as gy
it ddress
eer
THIS LINE
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Phone
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di
Sam 7 sv!'
Give co . ete .:s iption from d
Ozte
re ipt; e c
one
Phone,��=,
-n7,3
DESCRIPTION OF WORK: New Addition - Remodel
Size of Lo
ensions (Fra/ concrete, brick, etc.)
Roo Baths Basement
(Full, part, none)
Heat. System
Use of Bldg.
Moving
Sewage System
Bldg. Zone
_ Typ- of Roof'
.I
Found. ion Const
g
Fire Zone \�
Stes
Total Sq. Ft
tion - D�
0y- Valua
Chimney Fireplace
(Kind) (Number)
Ext F is. InQ Wall Finish
of nits Bedrooms
Garage or Carport Attached
Private Detatche
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 buildings; (6) location of sewage sys-
tem and water supply lines.
H
NORTH
,h1"
I he
as show
UTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
'1 Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
certify infor .t- on submitted is correct and there are no other structures located on this property except
ner o Agent
A LAND USE "T STRU TURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will b
Sewage Permit Number Issued
Remarks
DO NOT
BELOW THIS LINE
uilding Permit
e zone is
`/%•V// Receipt
Form 523 Bldg. Code