1978, 02-09 Permit App: M4882 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT At
GENERAL REQUIREMENTS PERMIT FEE It.SU ®
SNIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of ang
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
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 Owner / t _. •I Address Phone QUO — 7 1%
Architect Address Phone
Engineer Address Phone
Contractor Address Phone -
Legal Description qf Property (Give criplete description from) deed, tax re eipt, etc.) Parcel tuber
flOAQ cVA.Y R/uJ .5 a
,1
)0041127V-,
DESCRIPTION OF WORK: New X Addition R_ Rem
Size of Lot [/I 4d ✓ • / / ft
Stories LD'nnena s i(rh i�/// t- as'ymss/'
Rooms 4'1 Baths Full, aseme
partn
,orgiLt/t b4eyV ? --.42667P(57‘6,25
Moving Bid Zone Fire Zone N-1
i.
Sewage Systemonst.,
/� Co
R rlil�i^Lca=J'
Total Sq F[ Value on / G��V
oundation Const
Cflt}rGC svjChimne ire lace
Heat. System /--En T pe rdf,Ctoofing C -QY)_h Ext
Use of Bldg.%al-n L(4
(Kind) A (Num 6er
Finish
Int ofWallU its. e'Ir'- 1 Yp^nd'C--�J
��' No of Units Bedrooms✓�J
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.
m
wr
IA
N
NORTH
SOUTH
CAA) LA
—0 /
COMMERCIAL
REQUIRED
Plumbing Permi
Heating Permi
Sewage Penni
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
hereby cer/ fy informatioubmitted is correct and here are no other stru .tures located on this property except
Owner or Agent _ Date
A LAND U E OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
(Z 141 zi..p3a DO NOT WRITE BELOW THIS LINE //77 ����p^-� '""""
Your street address will be 6-/ O 9 -6 t -it -u n,t fi_ 'Ad./ dr �� A The zone is i4 O , _YA.G9, /
Sewage Permit Number Issued Building Permit Al-\ Receipt (2J'C3 Issued /
igjtemarks
Form 523 Bldg. Code
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