1977, 11-02 Permit App: M4017 ResidenceCounty of Spokane® Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
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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.
MOVING40F BUILDINGS. A permit is required to move an existing building. When a building is moved on a County or Stat
Highway, clearance must be obtained from the County Engineer and/or State Highway Department. u
andwhACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit. 4
RESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running with the land-
which
ich are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
1___) - APPLICANT FILL IN BELOW THIS LINE
Name of Owner ` Address A Phone `-% ZZ =99 S�
Architect Addressc7l Phone
Engineer Address.�3 G �s� Phone
ContractorAddress Phone
Legal Description of Property (Give complete description fjom deed, tax receipt, etc.)
DESCRIPTION OF W K: New Addition Remodel Moving Bld Zo / Fire one 3
Size of Lot Sewage System _;—
onst.
// (Fr., Conc., Br., etc.) or_
Stor Dimensions 4 Total Sq. Ft'�aluation li U DOd
Rooms _7 Baths Basement Foundation Const.. Chimne Fireplace
Full, part, none (Kind) (Numb
Heat. System` i Type of Roof' g Ext. Finish Int. Wall FinishL-c%
Use of Bldg, F ,ice , No. of Units ,L. Bedrooms4—
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. ,
CA
1
AMERCIAL State Licen a No.
O
Ind. Ins. ct. No.
REQUIRED
Plumbing Permit 7 •� .CJS +
M Heating Permit 4aAg =_
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yA Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby Con information submitted is correct and there are no other structures located on this property except
as shown.
Owner or Agent Date
A LAND tkE70R STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
d11iti1"t1DO NOT WRITE BELOW THIS LINE
Your street address will be The zone is
Sewage Permit Number Issued Building Permit Receipt,y"/ Issued
Remarks
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Form 523 Bldg. Code
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