1978, 05-11 Permit App: M6662 Residence' ' 1
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT �(U v
GENERAL REQUIREMENTS PERMIT FEE.... 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.
NATER. Water supply must be approved by the County and State Health Departments. Where work on water connections disturbs r -
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
Name of Owner D/W,ti?C? A6j Address Phone �z --,u '3124
Architect Address Phone _
Engineer_ Address Phone
Contractor j-%-LIZ?04-4,yyL:)5l Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number
DESCRIPTION OF WORK: New I Addition Remodel Moving Bldg. Zone Fire Zone
i
Size of Lot ,X Sewage SystemjS CConst. - /`""f
(Fr., Conc., Br., etc.)
Stories Dimensions aN x qs #&Ae HfE n W " rz! XIc, DLL - Total Sq. Ft. ZF401 i Valuation 5:Nx%C;
Rooms E BathsBasement �r Foundation Const. ns, %4A Chimney Fireplace — Z
Fu I, part, none—� I Kin )I (Number
Heat. System 4 t` ,R Type of Roofingy Ext. Finish "T1 t I Int. Wall Finish
Use of Bldg. J r)� .,:� � r W✓, r�1 x}77, l� s I� lam, [ eL No. of Units Bedrooms —
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
op buildings; (4) distance to property lines acd streets; (5) dimensions of buildings; (6) location of sewage sys-
em and water supply lines.
NORTH State License No. j
of P --L
i
m
N
SOUTH
Ind. Ins. Acct. No.
RESIDENTIA - COMMERCIAL
REQUIRED
Plumbing Permits Sty%
m Heating Permit
iA
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify informationd is correct and ere are no other structures located on this property except
as shown. / / �" /7_ n r.
Owner or Agent
A LAND USE OR STRUCTURE PERMIT MUST
THIS IS NOT A PERMIT.
Date
ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE
" // a
�l
Your street address will be a
Sewage Permit Number_ Issued
Remarks
Form 523 Bldg. Code
Building Permit
e zone is ( -
Receipt -2 Issued _
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