1978, 06-15 Permit App: M6859 Residence, Renewal of M0627® •
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99 !CJI
APPLICATION FOR LAND USE OR STRUCTURE PERMIT r
GENERAL REQUIREMENTS PERMIT FEE._S v
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 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 oowater 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 C'VENANTS. Builders should check provisions of covenants or dedications and easements running with the land
which are eable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
Name of Own: - a e4.✓ Address
Architect / Address
Engineer Address
Contractor Address
L} uescription of Propert_ (Give complete de cription from ,:ed, tax receipt, etc.) Parcel Number
Phone
Phone
Phone
Phone
DESCRIPTION OF WORK: New Addition
G`� c 0 cf
Size of_Lot
Remodel
Moving B Zone
Sewage System CConst.
(Fr., Co gr., etc.)
Stories Dimensions / Total Sq Ft Velvet o''YyT("(no J
Rooms Baths ✓q Basement Foundation ConstJ�r�j'[G¢G Chimney Fireplace �'—J
,,nn IPA', part, non /� �//� ,I n Kind)
(Number
Heat. System�L�� Type of Roofing L-1 Ext Finish �' — //7 Int Wall Finish ,c/
Use Rf Bldg. 0o No of Units_BedroonX 3
PLOT PLAN
K 6i
Fire Z• re
T
Draw etch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
propose uildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
NORTH d0 q
H
SOUTH
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL — COMMERCIAL
REQUIRED
Plumbing Permit
▪ Heating Permit
N Sewage Permit
y
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I her,j'ertlfy inf.r on submitted is correct and there are no other structures located on this property except
shown.
Owner or Ag;LIr Date
A JTD USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
7 S 1S NOT A PERMIT.
(3-4.c. 14 n yo ` DO NOT WRITE BELOW THIS LINE
41. at rev
�1
Tour street address will
Sewage Permit Number Issued
Remarks
Building Permit
The zone is .1.4.117
Receipt' Issued
v Kra
u-/
Form 523 Bldg. Code