1972, 02-25 Permit App: J1960 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401 0
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE ............................
"IT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any
ind or alter any building or structure already erected, or to change a land use. Construction mast conform with the
pokane 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 ingrest
4UNTY
d egress.
ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
rformed 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 Er_gineer 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.
APP IC NT FILL I" BELOW THIS LINE
Name of Owner --Address Phone
Architect 10,Phone Engineer Phone
Contractors Address Phone
Legal Description of r perty (Givq, coigplete description from deed, tax receipt, etc.)
DESCRIPTION OF WORK: New k--- Addition Remodel Moving Bldg. Zone Fire Zone 3.
Size of Lot ��� 3 76 — �� _ �O Cl - `%a � / S �/ Sewage System an i(Stories
Const. K= Dimensions Total Sq. Ft. Valuation
( Frame, concrete, brick, tc.) 76 gQ
Rooms_ Baths Basement L L / Foundation Const. C 0 ri C J- P- l Chimney Fireplace
(Full, part, none) (Kind) (Number)
Heat. System Type of Roofing - E t. Fi 'sh nt. Wall Finish
Use of Bldg. No. of Units Bedrooms
Garage or Carport Attached 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
i�
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State License No.
i
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
wn Heating Permit
D Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information z& sub d is correct and there are no other structures located on this property except
as shown. /� , r7�
G
Ow'14/r or Agent Date
A -LAND USE OR STRUCTURE PERMIT MUST BE ON T HE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 13 NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be C19 e zone is '
Sewage Permit Number Issued Building Permit Receipt _Issued
Remarks 11L� 1",4,
Form 523 Bldg. Coda
x
16
ONN
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