1972, 11-28 Permit App: K177 ResidenceAPPROVED AS NOTED
6r rrt ! qty Bldg. Cotte Dept.
County of Spokane, Washington � 2
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGT 20
APPLICATION FOR LAND USE OR STRUCTURE PERMIT s -g
PERMIT FEE
GENERAL REQUIREMENTS
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
Architect
Contractor
Legal escription of erty (Give complete
ddress
Engineer Phone
Address / Phone
Phone g2F /717
scr ; tion from deed, tax
rec
ipt, et
/#,
DESCRIPTION OF WORK: New Y Addition Remodel Moving
Size of Lot ,317 X /9d X! 96 X .2/0
Bldg
/ ,2Sewage System
.f4
Const. z� Dimensions f f " X 3? = 6 X/6"� Total Sq. Ft.
(Frame, concrete, brick etc.)
Baths JJ Basemen tjf Foundation Const.
uli, part, none)
Riym
e
Syste
Use of Bldg.
Garage or Carport Attached
Type of Rging
Zone / Fire Zone
Stories o�
Valuation :
Ext. Finish
r///
Chimnn�%6y�w� Fireplace
(Kind) (--� (Number
Int Wall Finish (//
No. of Units Bedrooms5
Private Detatched
J
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.
m
1
NORTH
SOUTH
I hereby cerp, information s
as shown.
Owner or Agent
itted
correct and ther
State License No.
Inc, Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
are no other structures located on this property except
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMIT.
1�
Your street address will be
Sewage Permit Number
Remarks
DO NOT WRITE BELOW THIS LINE
Date
CONSTRUCTION COMMENCES.
Issued
Building
e zone is
Receipt's- 9 Issued
(77
Form 523 Bldg. Code