1978, 06-26 Permit App: M7024 PoolCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT a 7
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.
Name of Owner
Architect Address
Engineer
APPLICANT FILL IN BELOW THIS LINE
Address 1 /"?/
Contractor
Phone
Phone
Address Phone
Address JO. Rejoe' /`/7G 7W r Phone
??o?/‘
ag-69g.3
Le al Description of Pro. ' y (Give complete description from deed, tax receipt, etc.) Parcel Number 12/s6' /`rte -
KUAUWAY K/W WIDTH
DESCRIPTION OF WORK: New Addition Remodel
Moving BId Zone / Fire Zone 3
Size of Lot /6- 7 i %x" / Sewage System =� � (Fr., Conc. tc.) oc
Stories ___:__Dimensions /6 / X 3� Total Sq. Ft �� - Valuation ��j 6O0
Rooms Baths Basement _ Foundation Const [sem' Chimney — Fireplace
Fu 1, part, none) �_ (Kind) _ (Num r
Heat. System Type of Roofing Ext. Finish Int. Wall Finish
Use of Bldg. Po -4 No. of Units Bedrooms
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.
CS)k° \
A
en
iA
NORTH /s -a /
17
/
z- - /3` �e
SOUTH
I hereby certify informs on submitted is correct and there are no other structures located on this property except
as shown. (p (/2 6 /70
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL COMMERCIAL
REQUIRED
�✓ Plumbing Permit
rw Heating Permit
� {A
▪ Sewage Permit
Plans Received
• Plans Checked
Plans Returned
Plans Picked Up
Plans ailed
74 ft(
Owner or Agent
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
/2. //'/ Calc;17 7176-rr
Building Permi
b .Gly
//�7The zone is ��lt�
Receipt 5/39 Issued
Form 523 Bldg. Code