1971, 09-07 Permit App: J0592 PoolCounty of Spokane. Washin ton
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401
APPLICATION FOR LAND USE OR STRUCTURE PERMITJ4
GENERAL REQUIREMENTS PERMIT FE_�_________________
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 Owner21� ddress � JW c I L L,' - ruone • - -� 'Z
Architect � Phone gineer Phone
Contractorp U � Address Chze
Phone 1'✓l� ['J
Legal Description of Pro erty (Give complete description from deed, taxes receipt, etc.) t/
DESCRIPTION OF WORK: New Addition
Size of Lot
(Frame, concrete, bricWetc.)
Remodel
Rooms Baths Basement Foundation Const.
(Full, part, none)
Heat. System Type of Roofing
Use of Bldg. &2�.d EL Q , -
Ext.
PLOT PLAN
Moving Bldg. Zone % Fire Zone
_ Sewage System Stori s -
-Total Sq. Ft. ,2Z 5- Valuatio
Chimney Fireplace
(Kind) (Number)
Int. Wall Finish
_ No. of Units Bedrooms
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 aad streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
N State License No.
Ind. Ins. Acct. No.
SOUTH
REQUIRED
Plumbing Permit
M Heating Permit
a
N Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I here t certify i ation submi ted is rect and there are no other structures located on
this property except
as shown.
Owner or Agent 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 zone ism
sewage Permit Number Issued Building Permit Receipt Issued
Remarks
Form 523 Bldg. Code