1977, 11-17 Permit App: M4194 Residence1
fr County 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 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.
APPLIC NT FILL IN BELOW THIS�LIN_Ej��1���J ,/p /y
Name of Own Address
OiL�//_�/ one 7�i
Architect / Address /Phone _
Engineer - Address Phone
Contractor 2(2,720, Address Phan
Legaltescription g bescription of Property (Give complete description from deed, tax receipt, etc.) Parcel Num • -r /%I`!/ /_s
/4 l
if 1- a 75' s/74/ /� /7 �� �/ �i�iz � / .
v o j• -t/� 25' /1-15—
DESCRIPTION OF WORK: New / Addition Remodel Moving BI
Size of Lot
7s, X/n-o�
Stories / Dimensions
Rooms / Baths ; Ba art, no
Heat. Syste T pe of Roofing
Use of /Bldg.
in W'
/4_
Fire Zoma. :=S
Sewage System onst �--
r., Ctonc �
I Sq Ft Va Fireplace
Chi mne�.� Fireplace
(Numb
Int Wall Finish
No of Units—Bedrooms
Foundation Const
9 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.
PLOT PLAN
NORTH
herebyp rt ify/
S own.
SOUTH
N e License No.
lb
Ind. Ins. c . No.
RESIDENTIAL — COMMERCIAL
REQUIRED
Plumbing Permit
wr Heating Permit
in Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
ormat on submitted is cy ect and there are no other structures located on this property except
Amer or Agent i Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOTA PERMIT.
DO NOT WRI ELOW THIS LINE,/
NS/our street address will be /41111
_ - - nr // � / Ile
e zone is ./
.Sewage Permit Number Issued Building Permit ///JJ Receipt -Ire/ slued
Remarks F
77
Form 523 Bldg. Code
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