1972, 03-16 Permit App: J2183 Remodel4
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMI3
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 mast 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 =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 8'1(147235.
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 �� ,22 —Address 0-7 a %/ - 7 ` ss `-^-- phone
Phone
Contractor aZ Phone O/J
Leg 1 Descriptiono Property�(GS ec co Tete description_ from deed, tax receipt, etc.) (Ct.,/?
Q0
5
Architect Phone Engineer
Address S- / 0 a t✓ur
DESCRIPTION OF WORK: New Addition Remodel X Moving Bldg. Zone / Fire Zone
Sire of Lot / 3 e%' S '3 A 7,5"--- , \ Sewage System .c 0 1 Stort�e/� i�SO o�
C Dimensions Total Sq Ft /6G Valuation?
( 'ram concrete, brick, etc.)
Rooms Baths Basement Foundation Const Chimney Fireplace
(Kind) ; (Number)
Heat. System Ty of Roofing —Ext Finish Int. Wall Finish
Use of Bldg.—�, No. of Units •
Bedrooms
(Full, part, none)
Garage or Cuport Attached
Pnvute 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
I hereby cert
as shown. •
P1
-4
ti
State Licens No.
ri O`
Ind. Ins. Acct. t✓o
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
nformation subm d is correct and there are no other structures located on this property except
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT .4 PERMIT.
DO NOT WRITE BELOW THIS LINE
Date
CONSTRUCTION COMMENCES.
Your street address will be-;; 6 me zone 1� dim -c •.
Sewage Permit Number Issued Building Permltl, i; ,, Rece /'',Issued
Remarks
Form 523 Bldg. Coda