1978, 04-12 Permit App: M5788 ResidenceCounty of Spokane, . Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT i C�
\ GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure ()Nay
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 onwater 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 BELOW THIS LINE
Name of Owner Address 1 Phone
Architect Address/ 2
_ _ Phone
Engineer - _ Address Phone
Contractor Address -� /�t,p1�^+�
Legal Description of Property (Give c�plete�description from de� receipt, .I, N bei r iJ' �+ j` q - ( ill
ocr h
ROADWAY RNP WIDTH S f,/1
DESCRIPTION OF ORK: -SI
Addition.. Remodel Moving Bldg. Zo
Size of LoU.W A.�
1 j Sewage System
Storie
CNt
Roans Baths Basement Foundation Const Cc/ .W\ fQ Chimney
Fu 4 part, porta
E� a
mansions 1 s%S 4 `^-�1(L I4lO )'' Total Sq Ft
Heat. System
Use of Bldg.
T pe of Roofing
6 c
Ext Finish Woo 1 Int [-�1
No of Units 4Sedroomav \
PLOT PLAN
ne —� Fire Zoe
Const r k"
r., asc 7 e c4
Valuation Firel
(Kind) Fireplace
Di (Number
Wall Finish Dr Wyl
Draw sketch with dimensions shawliYj: (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.
NORTH
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
w Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I her certify informationRubgitted is correct and there are no other structpres located on this property
as show J
Owner or Agen 6 Date t r\ ir8
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
Your street address will be 11 14 S M(, `, Z -\v t-+ 1r\ The zone is
Sewage Permit Number r � Issued Building Perm p s Q'Receipt J . Issued
except
DO NOT WRITE BELOW THIS LINE
Remarks
Form 523 Bldg. Code
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