1972, 08-14 Permit App: J4053 ResidenceCounty of Spokane. Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON "201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE______ _________________
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.
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 IN BELOW THIS LINE �%��� <,-
Name of OwnAddress //0,57� � u�— Phone _'
Architect Phone Engineer Phone
Contractor Address Phone
L sscption of Property (Give complete description fro n de , tax receipt, etc.) _ ::2—
�-C O
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. ne Fire Zone
Size of Lot Sewage System ti. �J Stories
Dimensions Total Sq. Ft. Valuation
Fra concrete, brick, etc. )
Rooms BathsBasement Foundation Const. l ' e4C-- Chimney Fireplace z^
Full, part, n ne) (Kind) (Number)
Heat. System/41 Type of Roofing Ext. Finish Int. Wall Finish
Use of Bldg. V_
Garage or Carporr Attache
No. of Units Bedrooms
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
rn
a
H
State Lic se No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Perrr"
Plans Receive
Plans Checke
Plans Return
Plans Picked
Plans Mailed
SOUTH
I he eby cert" y information submitted is correct and there are no other structures located on this property except
as shown l /
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
Form 523 Bldg. Code
Issued
DO NOT WRITE BELOW THIS LINE
P �0
Building
ane zone
Receipt _