1978, 05-05 Permit App: M6134 Residence0 •
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 47235.
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
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Name of Owner /� / .il-1'JC#C c, Address /v • /2 0 V cam✓"•"" 7X2/'6 Phone 7F -• s 3 F7
Architect Address Phone
Engineer Address Phone
Contractor —'G Address Phone -
Legal Description of Pro rty (Give complete description frrdeed, tax receipt, etc.) Parcel Number 03 S 7/ - YO2O 5'
ROADWAY R/W tiim =
Size of Lot gr X /91—
i
Stories / Dimensions riO
Rooms Baths__ Basement
Fu 1, part, not._,
Heat. System /` e r _, Type of Roofing C0 -Thr
DESCRIPTION ORK: New Addition'.
Remodel Moving Bldg Z r / Fire e
Sewage System In3
o�
st.
a
r' ` tc e 24 �r�•� 3 vaI C ., Br., etc.)
X ��''f oral Sq Ft /�u]WT�Vyluation r7 -5-V°
Foundation Const Chimney as Fireplace
(Number
E/ash _ Int Wall Finish
Use of Bldg.
/:f.<sr_ 4. /
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
No of Units ',Bedrooms
w sketch with dimensions showing: (1)
osed buildings; (4) distance to property
and water supply lines.r
NORTH
4
SOUTH
State/_License NAC
. `
Ind. Ins. Acct No.
RESIDENTIA COMMERCIAL
�� REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
s7s77sEttee
I hereby cert informt ubmitted is correct and there are no other structures located on this property except
as shown. I V S— _ - _ -7 (`i
b
Owner or gent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
TH49IS NOT A PERMIT.
fry-.•�1J1 DO NOT WRITE ELOW THIS LINE
t 6/3
r �J
our street address will be Lr /z-20 7 w
Sewage Permit Number
Remarks
Issued Building mit
zone 1s
Receipt (7 3 7 Issued
Form 523 Bldg. Code