1976, 12-08 Permit App: L6548 Residence+r
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201",
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
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 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
,iighway, clearance must be obtained from the County Engineer and/or State Highway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit.
Ri3STRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running with the land
wh ch 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 i i Address 2i /. Phone
Arch it0ct Address
Phone
Engineer Address Phone
Contractor - Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
F
DESCRIPTION OF WORK: New k Addition Remodel Moving Bldg, Zone Fire Zone
Size of Lot Sewage System onst. ` z
J
/. FFr., Cone.,Br., etc.)
Stories iL Dimensions Total S Ft - "
Q• �� Valuation -�, �
Rooms Baths Basement _ �/ Foundation Const. /� -Z% Chimney,%' -�
�� Full, part, none►(Kind) Fireplace —�—
(Number
Heat. SystemType of Roofing Ext. Finish Int. Wall Finish
Use of Bldg. _ .a �t Z� z ✓ ��e No. of Units -L 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
SOUTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit f -�
rw Heating Permit r
NSewage Permit }
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify information sut'3mitted is correct and there are no other structures located on this property except
as shown.
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MIi:ST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
6�DO WRI E BELOW THIS LINE
Your street address will be ���+►
"(
Sewage Permit Number The zone is
"IAL—_Issued Building Permi t U `✓ Receipt -
Remarks P Issued
Form 523 Bldg. Code
,J) /0 T- /V
/"--/o o 2 /`,' -z
�Cl