1971, 07-21 Permit App: J0128 Residence0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT off_
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 Stater
Highway, clearance must be obtained from the County Engineer and/or State Highway Department. i
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
i a _ t• A_l_ .. / is
Name of Owner --N `i `
Architect
Contractor
Legal Description of Property
Phone Engineer T
Address
(Give complete description from de
receipt, etc.)
...11 .l• v_. ..
Phone
Phone
DESCRIPTION OF WORK: New V Addition Remodel Moving Bldg. Zone Fire Zone
Size of Lot 4�"il)lr Sewage System £ Stories k
Const.�c Dimensions41 — X
I/ �-f" Total Sq. Ft. � ` Valuation
(Frame, concrete, brick, etc.) ,'� ;\ r�
Rooms Baths Basements Ss Foundation Const. <� C, s e 8 ChimneALI Fireplace �—
(Full, part, none) (Kind) (Number)
Heat. System Type of Roofing's — Ext. Finish Int. Wall Finish ' t' ii
Use of Bldg. 4' S i No. of Units_ Bed oms
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.
State Liy�nse No.
pfzlci) NORTH
C�
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit�'�`�
M Heating Permit n
NSewage Permit
•-1
SOUTH
I hereby certify infor witted is correct and there are no other
as slxown.i�``� /—
A LAND USE OR STRIA
THIS IS NOT A PERMIT.
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed _
es located on this property except
or Agent � 'D#te\
'TORE PERMIT MUST BE ON THE PREMISES BEFORE CONS UCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE
Your street address will be Z /0 -)-d Z—
Sewage Permit Number Issued BuiA�gPerm
Remarks
Form 523 Bldg. Code
The zone is �--
Receipt Issued
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