1971, 03-25 Permit App: I3802 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401
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 enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner `" Address 1 7 % /� Phone v
Architect Phone Engineer Phone
Contractor Address Phone
Legal Descri tion of Property (give complete description from deed, tax receipt, etc.)
DESCRIPTION OF ,O/RK: New Addition Remodel Moving Bldg. Zone 1 Fire Zone_
Size of Lot C Sewage System Stories
Const,_,-**-
onst Dimensions Total Sq. Ft. 5 Valuation` cl
(Frame, concrete, brick, etc.) 02
�� I
Rooms Baths � _ Basement Foundation Const. (�JryC�.�Co Chimney Fireplace
(Full, part, none) (Kind) ^ (Number)
�
Heat. ,ta
y ype of Roofing r _ Ext. Finish Int. Wall Finish 7 A--e-t �'
Use of Sstem Bldg. No. of Units Bedrooms
Garage or Carport Attached 4A d Lt -k `' Private Detatched
PLOT PLANdtocations;�(3)'
" `Draw sketch with dimensions showing: (1) property lines; (2) street or roalocation 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.
NORTHState License No.
Ind. Ins. Acct. No.
I�
ti
I h
as shown
SOUTH
ify infigp-�mitted is correct and there are no other structures located on this
REQUIRED
Plumbing Permit
rn Heating Permit
NSewage Permit
Plans Receiv(
Plans Checke
Plans Return
Plans Picked
Plans Mailed
except
I , �' or Agent Date �
A LAND SE O RUCTURE K9RMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be 3 Q o _ The zone is
Sewage Permit Number Issued Building Permit 3 Ka.2 Receipt Issued
Remarks
Form 523 Bldg. Code