1971, 05-20 Permit App: I4451 MH0
County of Spokane. Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT ,
GENERAL REQUIREMENTS PERMIT FEE_________________________
MMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any
ki]td 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. r
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. ddress / G "3 %� on�7-60,F v (. 17 Phone (J 1�— V/ 4 C o
Architect I' Phone Engineer Phone
Contractor •CkuST� Address % (�rLLy %� iy� iy ,�f Phone
Legal Description of Property (Give coplete description from died, tax receipt,
DESCRIPTION OF WORK: N/ew�Addition Remodel Moving � Bldg. ne Fire Zone
Size of Lot 9u) � �� Sewage System Storiee
Const. Dimensions Z- {� G' Total Sq. Ft. 2 C- Valuation % U O 0
(Frame, concrete, brit , etc.)
Rooms Baths Basement 0 Foundation Const. C4 a'^ Chimney Fireplace
(Full, part, none) (Kind) (Number)
Heat. System Type
%t� oofing ExFinish Int. Wall FinishUse of Bldg.No. of Units Bedrooms
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.
I hereby cert
as shown.
NORTH
SOUTH
informatiAn_ siftit
State Lice a No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
a
i/1 Sewage Permit
.4
Plans Received
Plans Checked
Plans Returned '
Plans Picked Up
Plans Mailed
there are no other structures located on this property except
Owner or Agent Date I
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOTA PERMIT.
DO NOT WRITE BELOW THIS LINE /
Your street address will be 197-4-3 e zone is "
Sewage Permit Number Issued Building Pe it 4tV S/ Receipt 5 " Issued
Remarks
Form 523 Bldg. Code
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