1973, 04-17 Permit App: K1320 Pool0 .00 ot
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE. SPOKANE, WASHINGTON 99401
APPLICATION FOR LAND USE OR STRUCTURE PERMI ;1
i
GENERAL REQUIREMENTS PERMIT FEE'..........................
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of silly
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.
WATER. 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 &gineer'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.
ents
whichlareVenforce ble throughrciviluld check action. Countysions Officialsocansnts or not bringdactionntosnd enforcemcovenanntsing or dedithe land
cations.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner QA'1 - �� Address / 06 � z 0J. Phone
Architect Phone Engineer Phone
Contractor o -o- lob Address 9 D I Phone
Legal Description o' f Property (Give complete description from deed, tax receipt, 'etc.)
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone Fire Zone'--+
Size of Lot A 7 X /3.4 / ] Sewage System Stories
Const. Dimensions
6 3 Z Total Sq. Ft. - �7� Z ValuatioK� �
(Frame, concrete, brick, etc.)
Rooms Baths Basement Foundation Const. Chimney Fireplace
(Kind) (Number)
� ..�. (Full, part, none)
Heat. System -a%�-�-�Type of Roofing�l Ext. Finish Int. Wall Finish
Use of Bldg. �,(�rii l'v-a-C No. of Units Bedrooms
Garage or Carport Attached Private Detatched
IN
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. L e se No
SOUTH
I hereby certify information submitted is correct and there are no other s
as shown. _ . A 11 i i
State ic
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
ictures orated on this property except
(liner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be1�"
Sewage Permit Number Issued
Remarks
Form 523 Bldg. Code
DO NOT WRITE BELOW THIS LINE
lding Permit
The zone is0_1�ssued_ Receipt