1974, 06-19 Permit App: K5000 Residence111
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
v•i
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.
NATER. 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 SOADS. Work on street right-of-way may not be performed until staked oy 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 2j -/ C-'
Name of Owner
Architect
Engineer
Contractor
is c • dt `— Address
L al Description of Propert
' c Phone -�— e/ 3 3
Address Phone
Address Phone
Address Phone
(Give complete dcesscription fro deed tax receipt, etc.) _ -5s-.. — 6
c.
-77 _ ,?•/9_ z• j, - —2,s— ^ VS .._
DESCRIPTION OF WORK: New X Addition
Size of Lot
Remodel
Moving BId. Zone Fire Zone
Sewage System
Stories / Dimens ons
Room Baths sement Foundation Const.
'-�. ulrpart, none)
Ha ifr Type
, Roofine -
Use of Bldg. e.1 -c_ -1C d (
t,;\1
t.
Conaf
Total Sq. Ft 7-2 d Valuation-
(Kind)
Firepl
y
Ext. Finish n ?e, l7t Int. Wall Finish
No. of Units _ Bedroom
Chimney
PLOT PLAN
Draw sketch withimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dime ions of buildings; (6) location of sewage sys-
tem and water supply lines.
7,441
Ct
m
t
0
01
NORTH
1
State LiceNo.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit/, --r
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I her b certif nformation submi ted is correct and the are no other structures located on this property ex'ept
as shown. �Sy%y� �/�� �/
c� L� ' . 6 /' ~ 77
Owner or Agent /'%Y Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
DO NOT WRITE BELOW THIS LINE
ermit/� DOcReceipt
Form 523 Bldg. Code
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