1972, 07-20 Permit App: J3796 MH1
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
vC."
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 covenantsor de cations.
� , e &2 3
4ame of Owner
lrchitect
APPLICANT FILL IN BELOW THIS LINE
;ontractor
Phone
_Address
Engineer
Address
,egal Description of Property (Give complete description from
j o 7 5 y /a ,C3�-( 6 3
Phone
Phone
Phone
dee, tax receipt, etc. ),/ •-3Q-4/3 - =?c J
near.
DESCRIPTION OF WORK: New Addition
Size of Lot /kid, aX,imensio
ns8 X 44
(Frame, concrete, brick, etc.)
Rooms —3 Baths _jL_ Basement
(Full, part, none)
Type of Roofing
Remodel Moving Bldg Zone / Fire Zone
Sewage System
Fleat. System
Jse of Bldg.
Foundation
-WCIAL
tiettc, Stories /
Total Sq. Ft. 1 ? 0 Valuation
Const. (- C- B-,-40'& himney
<3QDDf>D
Fireplace
(Kind) (Nu er)
�
Ext Finish �1Q� , Int. Wall Finish ((..y7�'k__
p e -(_ No. of Units Bedrooms _L
Private Detatched
:arage or Carport Attached
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations;
1posed buildings; (4) distance to property lines ar.d streets; (5) dimensions of buildings;
and water supply lines.
,t C Dv/Vi4I.,
NOAT 1�
l
/f 2, 5
SOUTH
Si certify 'n sru: o submitted is
correct
and there are no other
(3) location of existing and
(6) location of sewage sys-
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
structures located on this property except
Owner or Agent _ - - 7
E OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
A PERMIT.
" 4S C tress will be
DO NOT WRITE BELOW THIS LINE
vliLi `% i y
ember Issued Building Permit(
�i3� Receipt �W3 (v_ 3 Issued
e zone is