1972, 03-16 Permit App: K893 Pool• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
PERM$ 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.
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-BACKFROM 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 HJCHWAYs. 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 throng
00
b civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
gC
Name of Owner d �- � ddress ( /0 8"ye o g At/ 2
t/�phone � d"
Architect Phone Engineer P. Phone
Contractor -12 777. e r
AddrEss (en v T n /6 ' C..,4/Cct o.i°d Phone
Legal Desbript ion of Property (�rige complete description from deed, tax eceiptVV__etc,) O O 44/41/ - G 8 C %
h,A- /r /22.actifc a --eof, n.
DESCRIPTION OF WORK: New. A Addition Remodel _ Moving Bldg. Zone / Fire Zone
Size offLLot / 4 e s- 3 9-4 Sewage System Stories �
ConstL.+e,-,a Dimensions /6- X (3 '/ Total Sq Ft. .4 arc Valuation V✓J,el-
(Frame, concrete, brick, etc.)
Rooms—Baths Basement Foundation Const Chimney Fireplace
(Full, part, none) (Kind) (Number)
Heat. System �jj'�TypeRoofg Ext. Finish Int. Wall Finish
Use of Bldg ` No. of Units Bedrooms
q
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.
0
&mark
`.."--> tg
as shown.
I hereb is - 'gN'»+t srd�Itted is ; orrect and there are no other structures located on this property except
_iiiie or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOTA PERMIT.
\J Lice No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
DO NOT WRITE BELOW THIS LINE
Tour street address will be ( / 0 O �_ .a_e ., The zone ie1(7a.r ./�/
Sewage Permit Number Issued Building Permit 3 Receipte&G/-f Issued
Remarks
form 523 Bldg. Code