1977, 02-14 Permit App: L6935 MHCounty of- Spokane, Washington,
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT �7
GENERAL REQUIREMENTS PERMIT FEE 2-7 0 0 sj
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 lthe
Spokane County Building Code and.Zoning Ordinance. Construction is subject to inspection. .J
WATER. Water supply must be approved by the County and State Health Departments. Where work onwater connections disturbs
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
SE316E 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. Wherethestructure 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
Contractor
Legal sesc
Ii/
1
AO
inainr
.le descrip
ion
ropert
ve co
Address Phone
Address Phone
Address j/� Phone
Addres. wr• Phone
on/rom sed, tax receip
fit
ar
y
DESCRIPTION OF WORK: New 1/ Addition
Size of Lot 10j. X/ 3 S i
Stories _L�/Dimensions
Rooms Y Baths Z--< Basement Foundation Cons " Fhi
(Full, part, none 'wf_'.7
Heat. System Tr of oofing Ext Finis
Use of Bldg. `ti' �L C`-4 G��
Remodel
Moving BI g. Zone / Fire,e 3
4qan /0,0 Const
F C B
Valuation O d' O 0
.Va
(Kind) (Number
Sewage Syste '� onst.'�''r"'��
r., onc., r., etc.)
otal 9a Ft
mney Fireplace
Int Wall Finish /`va•--7-'`-""'"�
No of Units L Bedrooms
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.
14
tn
.4
NORTH
SOUTH
I hereby c y intormat'on submitt
as shown.
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
is correct and there are no other structure
stssr -d. - a IMe.1”`
r or Agent
A LAND USE OR I"RUCTURE PERMIT MUST BE ^ N HE PREMISES BEFORE CONSTRUCTION COMMENCES.
e+
located on this property except
/L 77
ate
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address •111
Sewage Permit Number
Remarks
Issued
Building Permit /f jSReceipt .4-i 78) Issued
Form 523 Bldg. Code