1977, 12-13 Permit App: M4385 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 mast 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
performeu 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
�'1 �? r °l S QTr /Address - �� Name of Owner � Y 1 Phone
Architect Address Phone
Engineer Address Phone
Contractor Address Phone
7zyCu /c.
Legal Description of Prsy (.Give complete description from de d, tax receipt, etc.) Parcel Number
L c - 4C k 2 m,‘ 5 "7 c k, /— . /7 g A, — — S�
DESCRIPTION OF WORK: New ')< Addition Remodel
Size of Lot -g ‘:-// *)( /1 ;, 3�
Stories ! .Dimensions 6,0 ' jn
Rooms Baths / Basement F-Z. L / Foundation Const
(Full, part, none)
Type of Roofing CQ Ext. .nish Lr.'Z e
Heat. System
Use of Bldg.
Moving Bldg. Zone / Fire Zone
• Sewage System - e ltc, onst. >`"L' 21Z
(Fr., Conc., Br., etc.)
Total Sq. Ft / (''? yaluatiorr
C L _ Chimney 2 /' Fireplace
(Kind)
Int. Wall Finish -'/
No. of Units Bedrooms
5
U 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
pa 194,2
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
m Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby cert€y information submitted is correct and there are no other structures located on this property except i/2 if—rtt
Owner o gent
as shown.
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Tour street address will be e The zone 113 "'
Sewage Permit Number Issued Building' ermit )/j Receipt (I� Issued
Remarks
Form 523 Bldg. Code
rt
1i94,5-
10 64
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