1973, 02-14 Permit App: K526 Repair Fire DamageCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
O�
PERMIT REQUIRED.'4 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. Wherethestructure 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.
Name of Owner
Architect
Contractor
`/' • PPLICANT FILL IN BELOW THIS LINE
ddress
Phone
Legal Description of Property (Give��/omplete descript
5 3 — �- J� — <1/416—c9 / `� O °!
LrL?-�U `%Lf -r) VA_
DESCRIPTION OF WORK: New
Size of Lot
y �/ «a -G Phone
gineerr,1 9Q 2-c) i�'� - Phone
ow' eon - S/6 /f .2 /Phone
on frgm deed, tax receipt, e c.) •5 3 /- c/ 'O,S 7
Moving Bldg. Zone / Fire Zone
Addition
Liu!/ V,{ ase
Remodel
Sewage System
ConstDimensions Total Sq. Ft. Valuation tarry
(Frame, concrete, brick, etc.) Iy
Rooms Baths Basement Foundation Const
(Full, part, none) (Kind)
Heat. System //%%Ty�pe of Ro�ofcing/ Ext Finish Int. Wall Finish
Use of Bldg. G..Z�t eJ Q �J No of Units Bedrooms
Stories
Chimney Fireplace
(Number)
Gar or Carpoyt7tttuehed /4_,1
Draw yketch with dimensioffs showing: (1)
proposed buildings; (4) distance to property
and water supply lines.
NORTH
Private Detatched
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
SOUTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify inf(patytkubmitted is correct and there are no other structures located on this property except
as shown.
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
fl
NOT WRITE BELOW THIS LINE
Your street address will be .527/y� 7 t T I S' €`- 41 """ The zone 1s
Sewage Permit NumberIssued _ Building Fermi t�r„ / Receipt
Remarks �b
4/703
Issued
Form 523 Bldg. Code