1972, 08-03 Permit App: J3984 Residence . County of Spokane. Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
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APPLICATION FOR LAND USE OR STRUCTURE PERMIT 55-
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.
WATER. 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.
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APPLICANT FILL Ill BELOW THIS LINE
A ! / �� ��. Phone 4— /J C
Name of Owne� �_/ � =` .r rens 64 y 1� /
Architect illif -...- _____________Phone Engineer _ 1 Phone
ContractorAddress AO Phone
Le 1 Deperirtion of Property (Give complete description from deed, tax receipt, etc.) _ /,s
DESCRIPTION OF WORK:New Addition Remodel Moving Bldg.Zone / Fire Zone 3
Size of Lot r4. 4) l z"../..,1-91.--1 Sewage System zs- Stories
_(� Total Sq. Ft. / 3 d Valuatio jkV
Const. t� Dimensions _ , - - `
(Frame,concrete,brick,etc.) �% k /� /. 4
Rooms_Baths a, Basemen_., // Foundation Const. 1 ---rJt,e.-.-I---f Chimney Fireplace
(Full, part, one) (Kind) (Number)
Heat. System q 1�Z j Type . Roofinp Ext. Finish — /// Int. Wall Finis
Use of Bldg. 1 .' J
No. of Units Bedr oms ?
I /`/
Garage or Carport AttacIrmo
Private Detatched
/ • ( 7 PLOT PLAN
Draw sketch with dimensions showing: i) property lines; (2) street or road locations; (3) location of existing and
oposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines. State License No.
NORTH ��
/ / , Ind. Ins. Acct. No.
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REQUIRED
bing Permit -C
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ing Permit (�/
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Sewage Pe ft',..-��
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Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify inform,/bion submitted�( is co rec��r..a.ndt ere''are n other structures located on this property exceptslitslitas sn. ii / iGF
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Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES. 4
THIS IS NOT A PERMIT.
e # ,A A., „ 19DO NOT WRITE BELOW THIS LINE 4110,
Your street address will be _ , r
_ _ _ The zone i- "" ` �`
Sewage Permit Number Izsued Build *emit Receipt Issue•
IReearks (1:2),,c"
114 I
Form 523 Bldg. Code
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