1971, 10-15 Permit App: J0994 MHCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE FERMI
GENERAL REQUIREMENTS PERMIT FEE' //
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erecta 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
ftpokane 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 ditchep of County Roads, permission must be obtained from the County Engineer's Office.
BdWAGE 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 thestructure 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 Address 91Z ei ZZeds • Phone yin7C'
Architect Phone Engineer Phone
Contractor Address Phone
Legs De cription of Property (Give complete descrlpt on from deed,. tax r=ce pt, etc.)
3 --3 �' 4t r' . r S]AIifJ�
3
DESCRIPTION OF WORK: New
Size of Lot S x H
J�
Const. 7 - Dimensions to y
(Frame, concrete, brick, etc.)
Rooms 3 Baths 1 Basement
(B part, none)
Type of Roofing
o
Addition
Remodel Moving Bldg. Zone
Sewage System C.7--;
Total Sq �Ft.
Foundation Const. `---G n.�/'%_Chimney
(Kind)
Finish/int. Wall Finish
No. of Units
Heat. System
Use of Bldg.
Garage or Carpor
Fire Zone
Storri /
��d Valuation' rCOC9
Attached
Bedrooms 2
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.
NORTH
aztirt
SOUTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
on Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify infortio bmltte. is correct and there are no other structures located on this pr
as shown. ,¢, ,
Or /
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PRE
THIS IS NOT A PERMIT.
Owner or Age
Date
ISES BEFORE CONSTRUCTION COMMENCES.
perty except
DO NOT WRITE BELOW THIS LINE
Your street address will be 4%; Q 6 /
Sewage Permit Number
Issued
Remarks
Building Permit
e zone Is
Receiptissued
Form 523 Bldg. Code
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