1971, 04-14 Permit App: I4079, Residence, Renewal of I1104•
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT..' �� 5 ()
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 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 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 BELOW THIS LINE
Name of Owner
Architect
Contractor�
Legal Description of Property (Give complete de�ription from deed, tax recce eipt, etc.) ' 715— ? — U / -s /
G_ i
Ph
ddress
ngineer
Address
ale
o4%1 sy2.
Phone
Phone
DESCRIPTION JOT, WOR .New Addition Remodel Moving Sewage
. ZOne Fire Zone S
Size of Lot /f77/ / X / X 4(5—(7 Sewage System tories 2�
Const Dimensions 22-2 5( -2 tf ",-"-/ ii 3 , Total Sq Ft. O 1? -2 Valuation
(Framg,,goperete, brick, etc.)
Rooms / Baths -2 Basement Foundation Const
0—Fie (Full, part, one)
Heat System Type of Roofing Ext Finish
Use of Bldg.
Chimney Fireplace
(Kind) (Number)
Int. Wall Finish
No. of Units Bedrooms
Garage or Carport Attached Prrvute Detatched
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.
NORTH
ez-ne_arte die ml
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit -
m Heating Permit
Sewage Permit
-I
Plans Received -
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby c tify information submitted is correct and there are no other structures located pn this property except
as shown/?
/IYJ�
Owner or Agent
Date
A LAND USE OR STRUCTURE PERMIT MUS'flE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOTA PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address w111 be / 7 2- 63 a /,e zone is ---41-----6.
Sewage Permit Numv ber Issued Building Permit ceipt ssued
Remarks ec-/(%if
Form 523 Bldg. Code