1978, 04-04 Permit App: M5632 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 enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE j /2 4.„Le.
Name of Owner 4,. �4, +dii, ,4r4 .i, Address / /,Z /1 ..2.1 f' . :i1-i -,'ICJ Phone 9.2,1- 6 7/6,,
Architect / Address / Phone
Engineer , Address Phone
Contractor - 44c? Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number O 8 5 4 - !J ..41-...2.5-
L.ZI
Nw W,Di H 41e-
DESCRIPTION OF WORK: New it
Size of Lot 6,6 X /% /r.%
Stories /.Dimensions o ?X
Rooms �� Baths /
(Furl, part, none)
j!-1, €
■ • 4
Addition
Remodel
�c C e_,, Foundation Const
fing
Moving Bld . Zone
Sewage System �-2 ICi Const.
(Fr., C
6 Total Sq. Ft / Q 6 2 �/
Basement r n�
t�� �7�y)( /c3
/...05=-7,
/ Fire one
onC., r., etc.)
lu lion ,3 DDD Qe
Chimney —± Fireplace /-
(Kind) QQ (N,uTbernn(�)�
int. Wall Finish /�.Js1, /V./7 X
No. of Units __Bedrooms 4;:e-
Heat. System
Use of Bldg.
Type of Rqp
j
s
Ext
Finish •7=///
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 acd streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
to
NORTH
altaila P''.
ti aT R,ECO RDD
as sh
SOUTH
I by certify informatio submitted is correct and there are no
Owner or gent Date
CONSTRUCTION COMMENCES.
State License No.
Ind. Ins. Acct. No.
RESIDENTI J- COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
WS477/ Ele-tj'V
other structures located on this property except
AND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS 1S 11,0T A PERMIT.
01/4/, 'ft/
Mir street address will be 71, / / ?�
Sewage Permit Number
Mir The zone is d-
Issued
Remarks Building Permit iv.-5-630- Receipt / (e Issued
DO NOT WRITE BELOW THIS LINE
Form 523 Bldg. Code
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