1973, 06-04 Permit App: K1849 ResidenceCounty p of S okane' Washington
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17- BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401
APPLICATION FOR LAND USE OR STRUCTURE PERMIT GENERAL REQUIREMENTS PERMIT FEE_.__q-1_______________
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.
NATER. 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 dress __21;;� A Phone, ,J7—
-1 Architect Phone Engineer Phone -
Contractor Address _ ��m��_ Phone
Legal Desr4iption of Property_ (give complete description from deeAV tax receipt, etc.)
DESCRIPTION OF WORK: New Addition Remodel Moving ldg. Zone ,,� Fire Zone 1-3
Size of Lot 'v /L -3a J Sewage System - Stories
Const. Dimensions )4 7 e') Total Sq. Ft. Valuation o2
(Fra onerete, brick, etc.) o
Rooms Baths Lk- Baseme Foundation Const.-e%-�'1�t� o�� Chimn fireplace
(Full, p none) (Kind) (Number)
Heat. Syste ype of Ro fing �2�f� . Ext. Fini Int. Wall Finish
G
Use of Bldg. XNo. of Units _ / Bedro s _�
Uarage or Ca ort Att: ed vate Detatched �✓�—!�
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
oposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
�J NORTH State License No.
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Ind. Ins. Acct. No.
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REQUIR D
Plumbing Per
M Heating Per
HSewage Permit
�1
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
hereby cgrtify,&formq,tigl submitted)is aomfeot and there are no other structures located on this property except
fiiaW_IWa
JA ->i 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 /��/ c The zone is i
sewage Permit Number Issued Building Permit /(! C- Receipt m2 Issued
Remarks ^V
Form 523 Bldg. Code
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