1977, 11-04 Permit App: M4040 Remodeli
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT Al
GENERAL REQUIREMENTS PERMIT FEE ..0-2•
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 most 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. •
t 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.
` PPLIC NT FILL IN BELOW THIS LI
Name of Own I/ / //. . L . i ..4 Address /. 1 -
Architect Address
Engineers ,��/ Address
Contractor7� (iw�/.9//I�C.GIf�/ Address/ - _ 1 _ /,
Legal Descripji of Prop (Give complete description from deed, tax receipt, etc.) Parcel Numb
/J
.4¢/t /j
Phone
Phone
Phone
Ph �1
'C///:
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg.
Sewage
Zone / Fi/ey)one
Sewage System Orr/„e
StoriesDimensi Total Sq Ft /5 Valuation
Rooms Bathe Basement Foundation Const Chimney Fireplace
u I, part, none !� '✓, ( r (Number
Heat. System T pe�•f Roofi w'J s# Ext Finish �jtf/9t Int Wall Finish 6 /24th L 4
Use of Bld
nd
No of Units .Bedroo
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.
NORTH
-I
Qty certify 1�i.-:t s P d is correc
Owner or Age
A LAND USE OR STRUCTURE PERMIT
THIS IS NOT A PERMIT.
COMMERCIAL
Plumbing Permit
tw Heating Permit
Sewage Permit
-I
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
ere are no other structures Located on this property except
Your street address will be
Sewage Permit Number Issued
Remarks
Date
ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
7
DO NOT WRIT _ ELOW THIS LINE
Building Permit
0
The zone•is be
ss d
Receipt AAVIssued
r/O
Form 523 Bldg. Code