1978, 03-15 Permit App: M5362 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 49201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT y `/
GENERAL REQUIREMENTS PERMIT FEE /
U
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 Rater connections disturbs t
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 1s 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 Owne
Architect
Contractor
Legal Desc
o Propert
Q
Give
L•C
NC Address O% 1 ' �j'°[k one 4 1' CIV•
Phone
Fngineer Phone
Address Phone
omQlete descr tonrom ed, tax rec :pt etc.) " (' S Y 2 — 2 9' 0-1-
___ 1I. 1b r / _.
4r OI
DESCRI r Ie OF WOR New Addition Remodel Moving Bldg.. Zone / Fire Z e
Size of of 1�� h Sewage Syste S Q-1 ' Stories
Const. Dimensions' & ■ ) �p' 2�X 1-1 uX Iti-:Zox 1Z Total Sq Ft I
(Frame, c24 rete, brick, etc.)
Rooms Baths
Basement r Foundation Const x-'� ..� AA
(Full, part, none)
Heat. System g F9 pe of Roofing Ext Finish
Use of Bldg.
Garage r Carport
Draw sketch with
proposed buildings; (
te and water supply
Valuation
Chimney l\l.} 4(— Fireplace CI\NQ-
(Kind) (Number)
Int. Wall Finish AC
No. of Units Bedroo s
Private Detatched
PLOT PLAN
dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
1 ines.
NORTH
-fbk
as sh
I her certi
SOUTH
REQUIRED
Plumbing Permit
m Heating Permit
yD, Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
in ma on s.bmitted is correct and there are no other structures located on tqis property except
7�
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THISIS NOTA PERMIT.
oi
tour street address will be
Sewage Permit Number Issued
Remarks
DO NOT WRITE BELOW THIS LINES
Nog 5,l`6
Building Permit
e zone is
Rece int ! 36? 2 -Issued
Form 523 Bldg. Code
4.407- ao . ILOGK .e
CA,Cc- WD>7704
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