1977, 06-15 Permit App: M1901 AdditionV
County of Spokane,. Washington
BUILDING CODES .DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 V A,
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE ............. I ..........
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a.building or structure of ally
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.
NATER. 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 untill 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 Address
Architect Address
Engineer Address
Contractor Address
Le al Description of Pro rty (Give complete descry' tion fromf�ad, I
recei
1 Parcel Number
Phone
Phone
Phone
Phone
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone _ Z Fire Zone
Size of Lot. / 3 G c3 — �l 5 Sewage System LA i' 5 2"'_onst. �� 9
Por.,Conc., Br etc.)
Stories Dimensions a Total Sq. Ft. Valuation -Z Od
Rooms BathsBasement Foundation Const.. Chimney Fireplace
Fu 1, part, none) (Kind) (Numb
Heat. System 5XS Type of Roofing E . Finish 1.Int. Wall Finish '
Use of Bldg. J No. of Units._.Bedrooms
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2).street or road to ations; (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
State License No.
Ind. -Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
M Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information submitted is correct and there are no other structures ocated.on this property except
as shown.
l�V Owner or Agent D e
A LAND: USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
Form 523 Bldg. Code
DO NOT WRITE BELOW THIS LINE
J
The zone is
Receipt In h Issued