1974, 07-08 Permit App: K5170 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
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 ' ' it i" .` . Address Phone
M
Architect Address Phone
Engineer Address �/ Phone
Contractor s —� C22' a ,S' -f-7-2 Address /G7/7 .,,...1. Phone 5?cr—f%Oc6---
Legal Description of P
Y (Give complete description from deed, tax receipt, etc
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone �L Fire Z
Sewage System ,..1. -2 -42,. -Const
ons
�� �Fr., Copt fir., etc.)
r/
Stories imensions 0p X �* Total Sq. Ft. ua on t'r-?3 Ot2O
Rooms `s( -Baths f Basement Foundation Const. —e-4/ .eChimney Fireplace
(Full, part, n �-- (Number
Ext. Finish e Int. Wall Finish�l Q .{�
No. of Units _,A edroo� .
AireZ----Z- ' C:2 --"e'
Size of Lot
/G6` X/2B
Heat. Syste
Use of Bldg.
(Kind)
PLOT PL
aw sketch with dimensions showing: (1)
oposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
property lines; (2) street or road locations;
location of existing and
1
As' T.mowr3oeNs
State License No.
-c, ,5`�G
Ind. Ins. Acct. No.
,2—
REQUIRED �%
Plumbing Permit —"
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I her by cert'ffyy information submitted is correct and there are no other structures located on this property except
as show �" t2
�`'%� 7/17
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT APERMIT.
7�, "DO NOT WRITE BELOW THIS LINE
Your street address will be
Sewage Permit Number
The zone is iq l0 so A
Receipt Issued
Remarks
Form 523 Bldg. Code