1971, 05-07 Permit App I4300 Pool0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99401
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE .... /pZ______..____--
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 most 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 ccovenants or dedications.
r n, —1ejPPLIgANT FILL IN BELOW THIS LINE _ ,n //1 9��1
Name of Owne a ress Phony eZL2
Architect Phone Engineer Phone
Contractor Address Phone
Legal,Pescription of Property fl*tu€ complete escr4*Sjgn from deed; t�c--r ipt, etc.) l ,G),,,_„_
DESCRIPTION OF WORK:
New Addition Remodel
Moving Bldg. Zone Fire Zone
Size q/C
Sewage System StorriiO
Co / -�
�imeasions r3�
Total Sq. Ft. -�/ Valuatioli
(F rame, con te, rt k, etc.)
—
Rooms Baths
Basement Foundation Const.
Chimney Fireplace
(Full,,part, none)
(Kind) (Number)
Heat. System
ype of Roofing Ext.
inish Int. Wall Finish
Use of WE
No. of Units Bedrooms
Garage or C Tpovt AttacIh,�,WPrivate
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. A
NORT�;.� /�/
State License No.
/
Ind. Ins. Acct. No.
REQUIRED
/yO
Plumbing Permit
M Heating Permit ?
m
30
yt Sewage Permit
y
y
Plans Received
J
Plans Checked
3%,
Plans Returned
Plans Picked Up
'n'1
�v
Plans Mailed
SOUTH
I hereby certify infpAmation submf ted U correct and there
are no other structures located on this property except
as shown. L--j� �
-!� D erry/ ������
_ -,7 �71
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO
Your street address will be—,za 's
Sewage Permit Number Issued
Remarks
Form 523 Bldg. Code
LINE
/ - The zone is
Building Permit _(), /,,— Receipt