1978, 04-12 Permit App: M5785 Residence1
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
kind or alter any building or structure already erected, or to change a land use. Construction must
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.
APPLICANT FILL IN BE • W THIS LINE
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
4
structure of any
conform with the
Name of Owner
Architect
Engineer
Contractor
Address
Address • Phone
Address Phone
Address - Phone . -
Legal Description of Property (Give complete description from deed,Aax receippgtc.) Parcel ce♦Number -
Phone 9""` 17-).12
ROADWAY R/W WIDTH
DESCRIPTION OF WO Ne Addition Remodel Moving Bldg. Zone / Fire Zeone
Size �of Lot�r G X 8,r) Sewage System r rt- onst. I-
S 'ice y r., Conc., qr., etc.)
j Stories _Dimensions iC4Li " ` 9. 1C'�
,��` dT �� w �' �� L� Total Sq Ft 4� Valuation ,
ooC'�ps T Baths Basement � t1t Foundation Cost Q`b\C ‘r C-14- Chimney Fireplace
C.
t- t� Fu I. part, none) _
Heat. System G t- A Tr of Roofing Ext Finish
Use of Bldg.
ersit
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.
( ind) (Number
Int. Wall Finish
No of Units ./...Bed oom>
NORTH
m
m
N
-I
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
ra Heating Permit
Sewage Permit
N
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I here ertify nformation ftubmitted is correct and there are no other structures located on this property except
Owner or Amen (Sack\
Q z, i 78
as shown.
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
C9,w 114, yam i 'Yt1 �] h� G`
Your street address will be [ 1 �-r FIn ,� : reit ( Y.1 `1 km b Q1 The zone is
Sewage
meal Permit Number Issued Building Permit Receipt/ 7 -,ZZ Issued
DO NOT WRITE BELOW THIS LINE
57KS -
Form 523 Bldg. Code
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