1978, 09-12 Permit App: N0569 ResidenceCoin of Spokane, Washir1611
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99260
1
APPLICATION FOR LAND USE OR STRUCTURE PERMIT ri 67c)
GENERAL REQUIREMENTS PERMIT FEE 7l
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. Con-
struction must have inspections.
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 is required. See current
Spokane County Zoning Ordinance for all required set -backs.
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 performea 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 building (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_
Architect
Engineer_
Contractor
L
escription of Pro y (Give complete
Address
Address
Address
Address
Phone 6 g 7-- 0? 2-3
Phone
Phone
Phone
esc ption from deed, tax receipt, e c.) Parcel Num
DESCRIPTION OF WORK: New Addition Remodel Moving BId . Zone 7 Fire Zoje
Size of Lot .rGl D 1 i 31 ' Sewage SystemConst
�1 (� Z
Storie Dimensions (96 's6 r �` a` 4.- '1' /a)(/ �" �J�y Total Sq.Ft. �� Valuation
of/7'
Rooms Baths , Basement ' Foundation Const. � J.,-�,Z Chimney '��� Fireplace /
(Full, part, non (Kind) (Number
Heat. System Type of oofing C1 _ Ext. Finish '- //1 Int. Wall Finish
Use of Bldg. --'2 -e----) , 7- _ / e-,� �. int_ - d
ROADWAY R/W WIDTH
No. of Units Bedrooms 3
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
m
cn
SOUTH
by/c11f`tify. information s�t6m
1
is coecd the :/re
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
rn Heating Permit
NSewage Permit
—4
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
.r/s;-,/7 g
other structures located, on this property except
9
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT. P,FRMITS ARE NON-REFUNDABLE AND NON -TRANSFERABLE
DO NOT WRITE BELOW THIS LINE
/c9 -
Your street address will be
,Sewage Permit Number
Remarks
JS
Issued
—The zone is
Building Permit Receipt
1
,Ap-01A11-401
-2-411;Z:1 / • 6yt
4-9
cli-3 3 — 0 2_
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