1975, 02-13 Permit App K6717 Fire DamageCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE is
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or st
kind or alter any building or structure already erected, or to change a land use. Construction mast c
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 connec
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's
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 prope
least 25' is required, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yard are requ
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set-ba
and egress.
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department an
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 C
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
which are enforceable through civil action. County Officials can not bring action to enforce covenants or
APPLICANT FILL IN BELOW THIS LINE
ructure of any
inform with the
tions disturbs
Office.
rty line, of at
ired.
ck and ingress
d work must be
ounty or State
with the land
dedications.
Name of Owner
Architect
Engineer
Contractor
L:gal D=scripti of P ooerty (Gi omplete description from ed, tax receipt,
rvC f•c)eaO /Z,(J /6'- s —/S/e? e %fo
DESCRIPTION OF WORK: New Addition Remodel Moving
Size of Lot �� 7 X , ?0-d
Stories / Dimensions
Rooms Baths Basement Foundation Const
Full, part, none) (Kind)
Heat. System Type of Roofing Ext. Finish Int. Wall Finish
Address Phone
Address Phone
Address Phone
Address -��� - ��•� 'hone.
Bldg. Zone
�— Fire
Sewage System Const_
F r . , C.
�a )
cr., etc
Total Sq. Ft. Val :or ra
d ChimneyFireplace
(Number
Use of Bldg.
PLOT PLAN
No. of Units _ Bedrooms
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.
m
NORTH
SOUTH
I hereby �ertirfy inforiation submitted is corre t and there are no 0
RESIDENTIAL - COMMERCIAL
as shown.
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES
THIS IS NOT A PERMIT.
State Licen
se No.
Ind. Ins. A
cct. No.
REQUIRED
Plumbing Permit
m Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
ther structures located on this
property except
Date
BEFORE CONSTRUCTION COMMENCES.
DO NOT ,WRITE BELOW THIS LINE
Tour street address will be //Pao �! l�J2GIYf�?i
Sewage Permit Number Issued Building ermit
Remarks
The zone is
4, 7/7 Receipt 9a 4'" Issu
ed
Form 523 Bldg. Code