1972, 04-17 Permit App E1372 Furnace, Wtr Htr, RangeYour street address will
Sewage Permit Number Issued
Remarks
as shown.`
County of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERM!
GENERAL REQUIREMENTS PERMIT FE
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 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 -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 covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
Name of Owne .: �.. �� �ii 4.4_, ddress A ,///-.2 �-1"1- ;r -.L'.-'Phone l-`4; 73/f
Architect % Phone Engineer Phone
Contractor Address Phone ��
Legal Description of Property (Give�..com%]�ete description from doe tax exeipt, etc.) /
DESCRIPTION OF WORK: New X Addition Remodel
Size of Lot 5 /! / 3— Con�h Dimensions ,I- 4 i--0
ncrete, brick etc.)
Baths / Basement
(Full, part one)_
am- -�
at. System Type of Roofing`
of Bldg
— Ce."�
Moving
Sewage System
Total Sq. Ft
Foundation Const
Bad Zone Fire Zone �S
Sto
1 Valuati
Chimney
(Kind)
- Eat ' ish- %ld1 e_ Int. Wall Finis
-�-Q- No. of Units
Garage or Carport Attached
Fireplace
(Number)
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-
teyand water supply lines.
NORTH
SOUTH
State Licen No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby f$rtify in or tion suin tted 1 correct and there are no other structures located on this property except
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMIT.
be_i/.) fS, e (-C' /
`" The zone is -12-e-
Building Perm' Receipt?. ,• Iss d
DO NOT WRITE BELOW THIS LINE
/2
Date
CONSTRUCTION COMMENCES.
1
Form 523 Bldg. Code