1972, 08-08 Permit App: J4026 Addition0
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99201
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APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE 1
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of an/
kind or alter any building or structure already erected, or to change a land use. Construction most 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 113 BELOW THIS LINE
Name of Ownerrx 9c �� / i Address —71 e Phoneu✓ Q� ( )7.320'
Architect
Contractor
Phone Engineer Phone
Address
Phone
Lege Descriptio of Property (Give com t escription from deed, tax receipt, etc..))t•----12'V S_
DESCRIPTION OF WORK: 1`New Addition x Remodel Moving Bld: Zon Fire Zone �—
(Af 0 � �- 2 Sewage System _St� 60
,
Dimensions /.%- x/' Total Sq. Ft. / uatio
Cgps
rete, brick, etc.)
ms_ Baths Basement Foundation Const
(Full, part, none)
Heat. System Type of Roofing
Use of Bldg. �---14,,,ekr
Garage or Carport Attached
Size of Lot
Chimney Fir ace
(Kind) (Number)
Int. Wall Finish
No. of Units Bed 'oms
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 arid streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
m
to
.01
NORTH
o
to O 41/4
41
1---
30
42447,
/
_46
0
State License
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certif iinformat on submitte/ is correct and there are no other structures located on this property except
as shown. / , ^ ,_ / ,__....
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE .
Your street address will be
Sewage Permit Number
Remarks
216 The zone i
Issued Building
Receipt
sued
(
Form 523 Bldg. Code