1977, 09-15 Permit App: M3329 Complete Residence-Voidth
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT Q 00
GENERAL REQUIREMENTS PERMIT FEE .1/ -
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 oneater 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 thestructure 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 /r O/(
G
Name of Owner Address
Architect / - Address
Engineer
.Contractor
Phone
Phone
Address Phone
Address / Phone -
Legal Description of Property (Give complete description from deed. tax receipt, etc.) Parcel_Number / 5-5-q - 9li /
926-3-2pq
5 71 7 52- E /4,5' 1- 7 5%2- 1 5E 7st SA -Pie
DESCRIPTION OF WORK: New Addition Remodel )( Moving Bldg. Zone _/ Fire Zone
Sewage System_ e /&s t
Size of Lot /34 'X /
3
R.st.
_ n..Conc. Br., etc.)
Stories_LDimensions - Total Sq. Ft. /3d49 Valuatio4/C7n0o0
�, Basement T Chimney (Kind) Fireplace
(Number
Int Wof llU i Finish Bedr ms f—Q�_P
o of Units �Bedr ms 2 --
Rooms _ Baths
Heat. System
Use of Bldg.
Fu I artnone
E.1.- .54 Type of Roofing
Foundation Const
Ext Finish
0 /3"--€1-4-0-5-702.4-,/ A,�/
a - PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations;
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings;
tem and water supply lines.
NORTH
I hereb
as shown. .
X
on
SOUTH
ubmitted is correct and
Owner or A
(3) location of existing and
(6) location of sewage sys-
State License No.
Ind. Ins. Acct. No.
)SIDENTIAL COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
there are no other structures located on this
ate
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
property except
DO NOT WRITE BELOW THIS LINE
Your street address w111 be
Sewage Permit Number Issued Building Permit
Remarks
The zone
Receipt
sued
Form 523 Bldg. Code.