1977, 05-14 Permit App: M1322 Residence4/7
County of Spokane, Wa59i ni gton
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT V/
GENERAL REQUIREMENTS .
PERMIT FEE...
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 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 thestructure 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 1s 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.
Name of Owner
Architect
Contractor
Legal Description o
APPLICANT FILL IN BELOW THIS LINE
Phone
•r,perty (Give compleite de iption fr deevC tax rece'pt, etc.)
II term )(ISA-
Nft
ddress k ! �►' \y• one
ngineer Phone
Address Phone
SO IS
'bVl
DESCRIPTIO77cNr OF WORK: New LVy� Addition Remodel Moving Bldg. Zon��e../I.. / Fire Zone J
Size of Lot U.11._, v C h, 3'�— Sewage System SP ff /G Stori s I
Const, Y 1`:V�� Dimensions
y A") xi C�-5.f.- )-A' ),Total Sq Ft 15:3>, Valuation at (7 0(C) 1
(Frame, cgncrete, brie., etc.) (, /' �7
Rooms S Baths /'• Basement L- Foundation Const �l NV; (`C'it Q- Chimney 1� Fireplace
Heat. SystemCZS C
(Full, part, none) ` `1(Kind) (Number)
111. Type of Roofing \'V. ? Ext. Finish VV 00'� Int. Wall Finish
Use of Bldg. �' 1 No of Units 1 Bedroo 3
Private Detatched
Garage or Carport Attached
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
SOUTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
m Heating Permit
Sewage Permit
y
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I here11�� ertify inforpppgggtion( ubmitt d is correct and there are no other structures located on this property except
as shown
\ 'N -
7777 Own or Agent\ -�V�L`v',jd•'gyl¢\ , ca‘
D
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
C -v1
Your street address will bfV40 c s 0 /
Sewage Permit Number Issued
Remarks
DO NOT
RITE
THIS LINE
ilding Permit
e zone is
laReceipt 9,3G.(Is
Form 523 Bldg. Code
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