1978, 04-12 Permit App: M5787 ResidenceJ
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 9920
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
11 GENERAL REQUIREMENTS PERMIT FEE.
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of a3
® kind or alter any building or structure already erected, or to change a land use. Construction must conform with tb
$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 BELOW THIS LINE
Name of Owner Address
/ Phone
Architect a Address y (/ )�d� Phone
Engineer ��� Address ( ( Phone
Contractor Address Phone
Legal Description of Property Wive complete riptim from tax receipt, etc.) ParcelLatt Number 3 .7.. - 'c <fO I
K'kA tv‘„, -N-t-41 Aid NN
/
ROADWAY R/W WIDTH iD
DESCRIPTION OF ORK: )New AQditionp Remodel yrMoving Bld 2 e Fire Z e
�,L Size offLot $ .�13 '-$J — ��(• 19'-'��}P, .t " % � ,� Y - 7 �, • i3 Sewage System oust. rattly_ j,
*(k ilA`tk 4 �A ,C4 T /0.1 -� � C3 x Const
Conc.r.. (/c�d
Stories Dimensions �`' Total SqFt
Rooms .6 Baths Basement �' Foundation Const CY Valuatione
Fu I, part, none) Chimney Fireplace
C-
%run'
( md) (j INuminr
Heat. System - t' T e of Roofing Q^/ Ext finis WC -v-2 'v\ Int Wall Finish Y7/ry W'4-"
Use of Bldg. Psi � s.r' 7e/;: No of Units 4Bedrooms 3
0
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.
NORTH
024 "e -t
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL — COMMERCIAL
REQUIRED
Plumbing Permit
m Heating Permit {{a
NSewage Permit ,P
1
Plans Received
SOUTH
I
here certify ',afar tion submitted
is correct and there are no other
'br Cat.\0���
OwerAgent
as shown.
Plans Checked
Plans Returned /
Plans Picked Up
Plans Matted
structures
located on this property except
Dale 4( U1( �en
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
(9M 7
DO NOT WRITE BELOW THIS LINE
Amt
Your street address will be ( 1 15 5 t' -4r I C1 . }'s' N1j1. J l me zone is '
Sewage Permit Number Issued l Building Permit �) Receipt ,_ ._ issued
Remarks r
Form 523 Bldg. Code
1.7 5, Ena y Pf ec11l -
D r / &&-03
ova y ph -am) .2 Ad
Add:-/'on
OA2cEc # 0265 V?- 31/o1.