1971, 04-27 Permit App: I4136 Residence0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON
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.
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 enfo able through civil action. County Officials can not bring action to enforce covenants or dedications.
, � A APPLICANT FILL IN BELOW THIS LINE /)
Name of owner ddress !
Architectone Engineer
Contractor AJ Address
Legal Descr ptio f Propertyjive complete description from deed, tax receipt, etc.)
PhoneXT
Phone
Phone
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zoe Fire Zone 3
Size of Lot Sewage System Stories
d
Const. Dimensions Total Sq. Ft. ���: Valuation J
(Fram oncrete, brick, etc.) ---
Rooms Baths _ Basement4 Foundation Const. Chimney Fireplace
(Full, part, none) (Kind) (Number)
Heat. System Type of Roofing Ext. Finish Int. Wall Finish
Use of Bldg. No. of Units Bedro ms
Garage or Carport tac ed Private 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 stre ) dimens of buildings; (6) location of sewage sys-
m and water supply lines.
NORTH C.�-A S Lice e No.
Ino I rsr,No.
rn
M a
H L N
SOUTH
REQUIR D
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked U
Plans Mailed —
I hereby certify ij�formation submitted is correct and there are no other structures located on this property except
as _shown. ) / i -ate- 01 —1111 1 -
Owner or Agent
A LAND USE OR' STRUCTURE PERMIT MUS'
THIS IS NOT A PERMIT.
Your street address will
Sewage Permit Number
Remarks
Form 523 Bldg. Code
Date
BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE
3 e zone is
_ Issued Building Permitl�II " W Receipt I