1973, 10-09 Permit App: K3045 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.
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 fie' • 7,/;2 ----, Ay q�',�P&' Phone
Architect Phone Engineer Phone
Contractor Address Phone
Leg 1 Des rip ion of rope ty (Give complete cr. tion from dee t receipt, etc.)
® ��
DESCRIPTION OF WORK: New—L::-Addition Remodel Moving B g. Z e / Fire Zone
Size of Lo Sewage System Stories %
Const. Dimensions Total Sq. Ft. �/ 7�Valuation i�DB�J
(Fram , con te, brick, etc.) �7
Rooms Baths !y Basement L Foundation Const. r/'% '"� Chimney —' Fireplace
(Full, part, none) (Kind) (Number
Heat. System rBLD Type of Roofing Ext. Finish �2 Int. Wall Finish
Use of Bldg. -P No. of Units / Bed ooms
Garage or Carport Attached Private Detatched.
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations;
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings;
tem and water supply lines.
NORTH State License No.
(3) location of existing and
(6) location of sewage sys-
m
N
1
as
1
1
01
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Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit r¢
m Heating Permit '
a
t/1 Sewage Permit
1
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby ce tify . format' n submitted is cor__reec�c��'nd ther are oott}her7tctures locate on
07,J). _ms 9/
property except
6" Owner or Agent V 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 �� �)E, The zone is
Sewage Permit Number Issu Building Permit Receipt _Issued
Remarks/x �� �¢ /ai
Form 523 Bldg. Code