1977, 08-16 Permit App: M2890 Remodel ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
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 o f rceable through civil action. County Officials can not bring action to enforce covenants or dedications.
\ s APPLICANT FILL IN BELOW THIS LINE Ct. %
4- ?L - LXr- .t-�.t Address f� / �i /� Z- Phone 4')--
Address
Name of Owner a-0
Architect
Engineer
Contractor
Le
Address
Address
G fly 6,--
cf el 16,
escription of Property (Give complete d ip . from deed, tax receipt, etc.) Parcel Number
DESCRIPTION OF WORK: New Addition
Size of Lot ( S-7) 9--c%
Remodel
Moving Bldg. Zone
Phone
Phone
Fire Zo
Sewage System ryoust. -
(Fr., Co
etc.) d,.,
Stories Dimensions Total Sq. Ft Valuation rr
Basement Foundation Const 9('��.1�Gj Chimney Fireplace
(Full, part, novel /
(Kind) (Number
Heat. System Li Type of Roofing Ext. Finish Int. Wall Finish
Use of Bldg. 1. i �j„Q d l-c-4/74---, L_L No. of Units Bedrooms
PLOT PLAN
Rooms Baths
Draw sketch With dimensions showing: (1)
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
property lines; (2) street or road locations; (3) location of existing and
NORTH
SOUTH
I her ,* certif
as sh r bmitted is correct and there are no other structures located on t -s property except
• .. !// (
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL — COMMERCIAL
REQUIRED
Plumbing Permit
m Heating Permit
Sewage Permit
-1
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
Owner or Agent
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
//, 77
DO NOT WRITE BELOW THIS LINE
// ;
Tour street address will be G( 2- t �s The zone is
Sewage Permit Number Issued Building Permit Receipt q.:2- 7_." ssued
Remarks
Form 523 Bldg. Code