1972, 06-06 Permit App: J3362 ResidenceCounty of Spoka 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 mast 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 v`-'% % �/ Phone
Architect __Phone Engineer Phone
Contractor Address Phone
egaI D iption of Pro prty (Give complete description from deed, tax receipt, etc.) 3
DESCRIPTION OF WORK: New Addition Remodel Moving Bld one Fire Zone
Size of Lot Sewage Systeme Stories
C st. Dimensions x L Total Sq. Ft. Valuatil � O G
rame, 4Baths
bketc.) 77
s ent Foundation Const. Chimney Fireplace
rt, none) (Kind) (Number)
Heat. Systepe of Roofing-,Zl Ext. Finish
Int. Wall Finish
Use of BldgNo. of Units Bed oms
Garage or Carport Attached 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
M
N
in
a
State Lice a No.
Ind. Ins. Acct. No.
REQUIRED
w
Plumbing Permit
Heating Permit
Sewage Permit _
Plans Received _
Plans Checked _
Plans Returned.
Plans Picked Up
Plans Mailed —
SOUTH
I hereby ert' y information submittacL is c r ect and there re no other structures located on this property except
as shown.
DV.
Owner or Agknt Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTIO COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
y Zi`v -,
Your street address will be 6 � -3 / The zone i4 --t
sewage Permit Number Issued Building Perm i Receiptssue
Remarks
Form 523 Bldg. Code
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