1972, 11-02 Permit App J4913 MHCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS
PERMIT FEE.._,/,5._.
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structu... r.e 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 onwater 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 thestructure 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 P-Address%—
�'��� Phone �f/i3 foo
Architect Phone Engineer Phone
Contractor DOn oC�ao'/ 1k,� . Address _fes 2- y /�h� PhoneT
Le�l Description of/ Property (Give complete description from deed, tax receipt, etc.)
— Z >-- "F i
DESCRIPTION OF WORK: Ne !/Addition Remodel Moving Bldg. Zone � Fire Zone
Size of Lot /✓ Sewage System _XiJ Stories
Const. Dimensions Z.2 X ri Total Sq. Ft. 4L 6C Valuation dP
(Frame, concrete, brick, etc.) //JJ
Rooms�Baths Basement Foundation Const. &6c: !////� Chimne
(Full, part, none) Y Fireplace
Heat. System e?C_T / (Kind) (Number)
ype of Roofing �t. Finish
A Int. Wall Finish
Use of Bldg.
Garage or Carport Attached
No. of Units Bedrooms
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
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
rn Heating Permit
30 N Sewage Permit
N
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certif 1 rmation submittedis ct and there are no other structures located on this property except
as shown.
'Z�Z �f/C
Owner or Agent �% Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOTA PERMIT.
at, 2ud 4a LDO NOT WRITE BELOW THIS LINE
�J
Your street address will be f/' L G7 a zone is
sewage Permit Number Issued Building Per t Receipt �_(_ Issued
Remarks
F
Form 523 Bldg. Code