1971, 08-16 Permit App: J0378 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE. SPOKANE, WASHINGTON 99401
APPLICATION FOR LAN® USE OR STRUCTURE PERMI�
GENERAL REQUIREMENTS PERMIT FE ._>
_____________
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. Nater 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 car not bring action to enforce covenants or dedications.
APPLICA T FILL IF! BELOW THIS LINE
Name of Owner ddress Phe�"
Architect Phone Engineer Phone
Contractor � tai. Address 7// S' Phone Wh
Legal Description of Property (Give complete descri t on from deed, tax rete t etc.) _
41
DESCRIPTION OF WORK: New � Addition Remodel Moving Bldg. Zone —.,L—Fire Zone
Size of Lot v ` Sewage System QW -11" S� Stories
—
Const. Dimensions otal Sq. Ft. Valuation
(Frame, concrete, brick, etc.) _
Rooms A_ Baths L_ Basement ��Foundation Const. 0-=:iChimney Fireplace
ALA
(Vaill, part, none) (Kind) (Number)
Heat. System Type of Roofing Ext. Finish Int. Wall Finish
Use of Bldg. No. of Units Bedrooms
Garage or Ca>:port Attached Private 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. State License No.
NORTH
Ind. Ins. Acct. No.
36
REQUIRED
1-3
13 / Plumbing Permit
on Heating Permit
to J- y I Sewage Permit
> Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I heregy certify
submitted is correct and there are no other structures located on this property except
X
as shown.
I Y Owner or Agent Date /
A LAND USE OR STRUCTURE PERMIT MUST BE ON d HE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
Form A23 Rirl., r-4.
DO NOT WRITE BELOW THIS LIRE
Issued
Buil"ng Permit
Thezone is `-
Receipt ssued