1978, 03-01 Permit App: M5042 Replaces M1071•
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 6 0/
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.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner
Architect
Engineer 17
Contractor
L Address
Address � ',2 /� Phone
Address Phone
V u r414 -42-c4.4, Address Z.E 2 U -, L ` 1 1.67 Phone H -V I - x3 C
Leg 1 D scription of Pr rty ( ive compete de cription from eed, tax receipt, tc. P rcel Nuwbe 4 / .Z — 3 0 I
{3
Phone 3s i y
ROADWAY R/W y�yt1D'r}�
DES RIPTION CiF-O 00New v Addition
tones /
Dimensions +Z Y 7 sz -i-
Booms
Rooms Baths Z Basement <v./
(Fail, part, none
Heat. System Cie C F/11 • Type of Roofing
Siz of Lot
Use of Bldg. JA' df )
Remodel
� �X .2 ,'
Moving Bldg. Zone Fire Zone
Sewage System 59/2 const /"/#Z k Nve
��(Fr., Conc.,,Brr., etc.) 7.)
V•Iuation / 5d v
Total Sq. Ft
Foundation Const CCWC‘1t / ' Chimney era Fireplace
(Kind) (Number,
CUA/ Ext. Finish—// Int. Wall Finish OA-, 4./a
�/
No. of Units Bedrooms
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
prop ed buildings; (4) distance to property lines and streets; (5) dimensions obuilding.; (6) lo ation of s•; age ys-
t ;'nd w; supply lines.
Txp
6-7— ' REQUIRED
- COMMERCIAL
I herey cer
as shown. *
SOUTH
nfo� %'a)
edcorrect and there are no of
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
structures located on this property except
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS I� A PERMIT.
(( e
DO NOT WRITE BELOW THIS LINE
Yo> _ , 5' /trLet address will be 0C7 v
Sewage Permit Number Issued
Remarks
z“,e.,.‹_.
Building Permit
F.,rm t01 51,4„ retell-
The zone is 5 f"
} Receipt 63_5..__Z:. -Issued