1972, 11-08 Permit App: J4963 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 992
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.
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 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 Ute- � "- Address -`73,-O - �� f - Phone -h-- / ,//
4999
Architect Phone Engineer Phone
Contractor—'-�G'_.. Address
Phone
Legal_Dsspription of Property (Give/complete de r ion from deed, tax receipt, etc.) ®f
DESCRIPTIO OF WORK: New iK Addition _ Remodel Moving Bld Zone Fire Zone `�
Size of Lot � - „ ..mrd Sewage System - Stories /� "may --
�e 6'(,
Cc�t" Dimensions �� ✓� Total Sq. Ft. / Valuati�
concrete, brick, etc.) /
Baths / Basement Foundation Const 0--e--7----- Chimney Fireplace Gi2.—"
11, part, none)y (Kind) ) (Number)
Heat. Syste . .�._ ape of RoofingExt Finish / r Int. Wall Finish / f - •
a_
Use of Bldg. x�4. -.11.4,---,c__(-- e i a�a. No. of Units Bedr• ms
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.
44)
•
m
N
y
NORTH
as sh
SOUTH
I hereb certify informatAlli. s .- ►•. is
114- - �11.111
Owner or •g•.t
State L� No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
correct and there are no other structures located on this property except
Date
A LAND USE OR STRUCTURE PERMIT MUST - ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Sewage Permit Number /3 Issued Building Perm The zone
DO NOT WRITE BELOW THIS LINE
Your street address will be
ftL�3 Receipt' ��/� -sued
Remarks
ft
/
Form 523 Bldg. Code
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