1972, 06-26 Permit App: J3584 Residence Addition• r
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.
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 111 BELOW THIS LINE
Name of Owner + ddress�,
Architect Pho'• Engineer / Phone
Address Phone
Phone
Contractor 5 v is
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
ac/014 // ...z .3 c 1, <3,:V 7
r=. i•
DESCRIPTIQN OF WORK: New Addition
�*A N //7• --7,r /56: 31
Const. -1 itSG Dimensions
Size of Lot
Remodel
(Frame cncrete, brick, etc.)
Rooms 'f Baths i Baseme►M`!onndation Const
(Full, part, none)
Heat. System 6:04S Typ: • Roof' g CO • D Sri
6/ A/
Use of Bldg.
-Garage or Carport Attached
ail i
1171
Moving Fire Zone
a
Sewage Syste • _ .' ' �^ . �;� s (4'
Total Sq. Ft. • = • .- 0-,
37(e __
CD /
CEt N E Chimney Fireplace
(Kind) (Number)
Ext Finish SEX t I I Int. Wall Finish S� E- L()
.>!f . _Sr /Mr ai / .•,i..oAt - o. of Units Bedrooms 1
Bldg. Zone
Valuatio
Private Detatched
PLOT PLAN
1 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.
SOUTH
I hereby certify information submittgd
as shown.
is correct and t
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUS
THIS 1S NOT A PERMIT.
Your street address will be
Sewage Permit Number Issued
Remarks
State I/icense No.
aie .
Ino. Ins. Acct. N9.
REQUIRED
Plumbing Permit
Heating Permit7
-
D
gn Sewage Permit (f
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
re are no other structures located on this property except
Date
BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
N WRIT ELOW THIS LINE
Buildin: er
The zone
Receip
Issued
Form 523 Bldg. Code