1971, 11-16 Permit App: J1327 Addition•
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 an,y
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 nater 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
Derformed 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 moyed 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 -e -� - _Address
Architect 'hone Engineer -7� Phone _
Contractor ?mow__ Tom„ Address2 c 3 OO /4� , 0-- Phone - 0,- -.-----
(Give complete description from,d, , tax receipt, etc.) / O /
c -''mac•- c� � l� fl i' ,S—`/ / S'/O
J c)
.eons
DESCRIPTION OF WORK: New Addition Xs Remodel
Size of Lot / 3. -6'6
Coyer_- Dimensions' V'%! /2rams, cuncrete, brick, etc.l
Rooms Baths _ Basement Foundation Const
Moving' Bld•. Zone
Sewage System
Total Sq. Ft.
Q /(Full, part, one
Heat Systerri- e --5S /Type of Roofngy=y�'�'"/t ° -Ext. Finis
Use of Bldg. 1 rr»rf
Garage or Carport Attache
Chimney
Fire Zone
Ston s
Valuatiof 2 7OO
Fire ace
(Kind) (Number)
Int. Wall Finish
No. of Units — Bedro. s
P mute Det atched
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location ation foexistingsand
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; ()
tem and water supply lines. State_ L1se No.
NORTH
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit -
en Heating Permit i�� i- t_
s
y, Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOU TH
I hereby\\+�07,4 y information submitted is corre t and there are no other structures located on this property except
as shown. it // ,—! w
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
Date
Your street address will be
Sewage Permit Number
Remarks
DO NOT WRITE BELOW THIS LINE
,,"._ J o
Issued Building Permit
iJ21
zone 1
Receipt
ssued
Form 523 Bldg. Code