1978, 06-12 Permit App: M6711 PoolCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99
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 47235.
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.
�� tlAPPLICANT FILL IN BELOW THIS LINE
Name of Owner t�ziv-c.vt 4/4.veetf Address
Architect Address Phone
Engineer Address flung. n71h.. 77026 Phone
Contractor rvl(jY/f� �o- n� Address /�/ /.29/V i/%rrec�.a�rr Phone 4l66- S'/S7
Legal Description of Property (Give complete descriition from deed. tax receipt, etc.) Parcel umber r 8- / - avvL
yrs' 3 sem. 41►__. ,
?to/
C. /8//8 ate« ut_ cZ..e . Phone ?a6- 3516
DESCRIPTION OF WORK: New L— Addition
Size of Lot ? Va czc--C,o
� r
Stories LL,t��LDimensions !7 X 36
Rooms .E4. Baths MI Basement
(Full, part. none
�
Heat. System Terme— Type of Roofing �/
Use of Bldg. ,�...rcr„im,�nt-q/ Po,/
Remodel
Otto/
Foundation Const '7
Ext Finish
Moving Bld Zone Fire Zone .�
Sewage System csonst. 'nu' r..J Lt "
// (Fr.. Conc., Br., etc.) sr
Sq Ft lro / Z Valuation° 3 /O2
Chimney (Kind) Fireplace N her
Int Wall Finish d
No of Units Bedrooms ,v4
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
SOUTH
State License No.
K - c9
Ind. Ins. Ace(. No.
CESIDENTIA} COMMERCIAL
REQUIRED
Plumbing Permit
nr Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans M led
I yheer%by certify information submitted is correct and there are no other structures located on this property except
�s shownriteC 4J =s� L€ - G//2/7S
1"- Owner or Agent i/ 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
Sewage Permit Number Issued
Remarks
Building Permit
The zone is
Receipt
/(
Issued
Form 523 Bldg. Code