1976, 02-02 Permit App: L2526 ResidenceQ
Ctsinty 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 aexL,
kind or alter any building or structure already erected, or to change a land use. Construction must conform with tie
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection. 1`
WATER. Water supply must be approved by the County and State Health Departments. Where work onwater connections disturt9
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
Name of Owner - _ // Address c�
Architect Address
Engineer
Contractor
Legal Description of Property
Address
Address
ve complete description fr•m deed, tax receipt, et
Phone: --/77c
Phone
Phone
Phone
7Q
DESCRIPTION OF WORK: New X Addition
Size of Lot
Remodel
Moving
Stories /f Dimensions
Rooms /Baths
�e, linen, none
Reat. System _ Type of Roofing
Use of Bldg.
Sewage System
Bldg. ne ( Fire Zone
'� onst
.0 y % nc., Br., etc.)
�) Total Sq. Ft. Valuation � C0&
'Basement
[J
C---0—}"-,71-9
Foundation Const t(�r�1i �Chim ey Fireplace
' CV -:-
(Kind) (Number
Ext. Finish
.1
Int Wall Finish
No of Units— Bedroom J .�
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
ESIDENTIA COMMERCIAL
w
y
State License No.
i
Ind. Ins. Acct. No.
REQUIRED - fJn�i,'
Plumbing Permit s%i�"�"""(2C'
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown.
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
&Ac' 74(0 9/ / /v
Tour street address w111 be 3 The zone ism/ "//�)
���'6L.
Sewage Permit Number Issued Building Permit 0( 26r -.23 -Receipt /,202 Issued
Remarks
DO NOT WRITE BELOW THIS LINE
Form 523 Bldg. Code
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