1972, 09-28 Permit App: J4621 Residence• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE. SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT ( S `'
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or
kind or alter any building or structure already erected, or to change a land use. Construction mast
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 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.
z � c') cGy n LIC NT FILL IN BELOW THIS LINE
Name of Owner r�fjIIt) b ,t -JO'-tA% � Address /O'a i Jf}tl�S�j� phone W4 5 %C (�
Architect Phone Engineer Phone
Contractor Address Phone .a
structure of any
conform with the
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
b'LK
DESCRIPTION OF WORK: New X Addition Remodel
Size of Lot Si X /7' //7' 4'(,
Const. Dimensions 3 (v ` (L -7 " z7 ' K / O(
Moving Bldg. Zone / Fire Zone
Sewage System ' f) 71 C_ Stories
Total Sq. Ft I 41 / Valuation
3
(Frame, concrete, brick, etc.)
Rooms Baths 7 Basement --'--4- Foundation Const C� t' / 1 -
(Full, part, none)
Heat. System C ' "ut— Type of Roofing
Use of Bldg. 2(4)
Garage
Garage or Carport Attached C
Chimney Fireplace
(Kind) (Nu (ber)
Ext Finish Int. Wall Finish
No. of Units Bedrooms
Private Detitched
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 a'id streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
m
m
NORTH
SOUTH
I hereby certifinfory tion s
as shown.
bmitted is correct
and there are no
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
other structures located yut t 's prope ty except
her or f ,ge.nV Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
(544,11/040
Your street address will be
Sewage Permit Number Issued
Remarks
DO NOT WRITE BELOW THIS LINE
ilding P
The zone is
er�i Receipt ssued
Form 523 Bldg. Code