1976, 08-02 Permit App: L4941 RemodelCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
0
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 3
GENERAL REQUIREMENTS PERMIT FEE ___________________________
PERMIT REQUIRED. A land use or 'structure permit is required by County Resolution to erect a building or structure of arty
kind or alter any building of structure already erected, or to change a land use. Construction mast 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 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 99�
Name of Owner Address SQ Phone
Architect Address Phone.
Engineer Address Phone
Contractor �" Address V►�� = 49 Phone
Legal Descri tion of Property (Give complete description from deed, tax receipt, etc.)
DESCRIPTION OF WORK: New Addition Remodel_ Moving Bldg. Zone ___ _. Fire Zone
Size of Lot gQ X /,5A Sewage System NA onst.
Por., Conc., Br., etc.).6
Stories _-Dimensions _a -LX X Total Sq. Ft.,' _ a Valuation
Rooms -./— BathsBasement //��//� Foundation Const.. Chimney �A.Fireplace &A
Full, part, nonce (Kind) (Number
Heat. System yp=Roofing xt. Finish T' -!/f .Int. Wall Finish AZA
Use of Bldg. No. of Units —Bedrooms
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 RESIDENTIAL - COMMERCIAL State License No.
/ /_ E
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
M Heating Permit
)o
N Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOU TH
I her oert
y info mation submitted is correct and there are no other structures located on this property except
as shown.
s.1 � -
z v
Owner or Agent Date
A L ND US OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS'IS-N6T A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be .3The zone is
Sewage Permit Number Issued Building Permi Receipt o Issued
Remarks it
Form 523 Bldg. Code