1971, 07-21 Permit App: J0130 ResidenceF � 0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 49401
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
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.
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 covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner
Architect
(Iontractor_
Legal Degcription of ProRerty (Give
iz,e�� r, rte_ Aaoress
e Engineer
Address
le e description fom
.s
deed, tax receipt,
Phone ' 1 L
Phone
Phone
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone Fire Zone
Size of Lot �Z/ I :� ) �O z� l Sewage System Stories �—
Const<.— r n X -, Dimensions 1T`'Z ,�, `'21L Total Sq. Ft. Valuation V
(Frame, concrete, brick, etc.) \
Rooms 4- Baths Basement s �\ Foundation Const.c.• <<a hC C -\�- Chimney Fireplace J
•(Full, part, none) ��— (Kind) (Number)
Heat. System Type of Roofing Ext. Finish '! Int. Wall Finish G 1 -�
's
Use of Bldg. _,��� 5 L Le ti C No. of Units __ Bed oom.1—
Garage or Carport 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.
NORTH State Licens No.
CA
y
SOUTH
I hereby ce y informat' bmitted is correct and there are no
as shown.,
Ind. ns. Acct. No.
REQUIRED
Plumbing Permit -NS
M Heating Permit
a Sewage Permit u, 'e
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
r stkuctures located on this property except
or Agent Dat.
A LAND USE OR STRU'&TURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
Form 523 Bldg. Code
DO NOT WRITE BELOW THIS LINE
The zone
Receipt 2 .LIssued
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