1972, 02-22 Permit App: J1953 Addition• •
County of Spokane, Washington
BUILDING CODES DEPARTMENT. COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE "
PEWIT 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.
NATE HIGF:WAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
Wild 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 OR 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 IH BELOW THIS LINE
Name of Owner _Address / D / d E 7Z Phone 111//9' ‘14—O --f5 'J
Architect
Contractor
Leg.) Description of Property
Phone Engineer Phone
('.91/5 T , Address
(Giyeyee a description from deed, tax,rec etc.)
±/Q / 3 J,4 a.fa Phone whi '•5 > q /
o� y� /—a41-'ohr.
DESCRIPTION OF WORK: New
Size of Lot 1 3 3 x 3 a 6
Const /' �� Dimensions / g o< 3
(Frame, concrete, brick, etc.) /j�
Rooms / Baths Basement /10 Foundation Const.
(Full, part, none)
Type of Roofi
Addition !- Remodel
Moving Bldg. Zon
Sewage System
Total Sq. Ft 3/4.3 r%
Heat. System
Use of Bldg.
Fire Zone1�.L
Stories
Valuation a 0 o e ..
Chimney
(Kind)
t. Wall Fini
No. of Units Bedrooms
Private Detatched
Ext. Finish
Garage or Carport Attached
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
NORTH
Fireplace 0
(Number)
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
1,,026()
I here r certifj' in fipt mation
,as shown.
SOUTH
itted is correct and there are no other structures located on this property except
State License No.
/
a. 3—Q/—//7/6 d
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
iw Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
Owner or Agent
a— a ar72r
Date
A I,,AND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit 'Number Issued Building Pe Receipt 7fil
Remarks
/I DO NOT WRITE BELOW THIS LINE
D /0 ezi4 The zone is
I"sued
Form 523 Bldg. Code
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