1972, 09-28 Permit App: J4597 AdditionCounty of Spokane, Washington j
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON "201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL R E Q U I R E M E N T S PERMIT FEE--------- ------- --
PER1dIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building structu a ofany
kind or alter any building or structure already erected, or to change a land use. Construction mast 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 moped 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.
1 - - - - - - ( -21 7�
Name of Owner, �1 Address _�� Phone
Architect Phone Engineer Phone
Contractor Address Phone
Le`g"escriptiondof operty (give complete description from deed, tax receipt, etc.)
T, � ,/l cA /4'. /,i // , -4 1%1 /p7 //
DESCRIPTION OF W9RK: New ✓ ddii
Size of L
Con Dimensions �,
(Fra ,concrete, brick, etc.)
Roo s Baths Basement
(Full, part, none)
Heat. System. -Type of Roofing
Use of Bldg.
Garage or Carport tached
��emodel Moving Bldg. Zone Fire Zone
Sewage System Sto
Total Sq. Ft.�— Valuation
Foundation Const.
_ Ekt. F
Kvmey Fireplace
• (Kind) (Number)
_ Int. Wall Finish
No. of Units Bedrooms
Private Detatched
PLOT PLAY,
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. State License No.
Ind. Ins. Acct. No.
m
6A
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certy information suitted is corre athere are no other structures located on this property except
as shown. I
SP _
Own or Aeont Date
A LAND USE OR ST CTURF PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will ho
Sewage Permit Num er rssued Building Permit
Remarks
_ �_----
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ltaraipt slued