1978, 02-09 Permit App: M4886 Residence•
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
PERMIT FEE ._ttP7'SV
'GENERAL REQUIREMENTS
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of
kind or alter any building or structure already erected, or to change a land use. Construction mast conform with th
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 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.
PPLICANT FILL IN BELOW THIS LIN
Name of Owner
Architect
Engineer
Contractor
Legal Descri tion of Pro y (Give eprppllete description1 from dep�d, tax receipt, etc.)
-4 0
Addres
Address
Address
Address
PareliNr er
Phone
Phone
Phone
Phone
RD
DESCRIPTION OF WORK: New )C
Size of Lot ,/,./)...k.B
Dimensi , s x /7 - X .0 oVe2 40/ Total Sq. Ft 44/9C
Addition Remodel Moving Bldg Zone , l Fire Z
Sewage System
Stories 1
Rooms Bathe Basement
u I, part, n
Heat. System e�./9 Type o
Use of Bldg.
Foundation Const
Chimne
(Kind)
fdY Ext. Finish Int. Wall Fin
No. of Units
PLOT PLAN
Const.
(Fr., Co c., Br., etc.)
Vatuatfon9%' 7 / De.° *D°
eplace
(Num er
sh
1 Bedrdbms
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
SOUTH
m
N
State Licen6 No.
Wo 3
Ind. Ins. Acct. No.
RESIDENTIAL COMMERCIAL
Plumbing Pe
Heating Permit
Sewage Permit
-0/
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify info' tion submitted is correc and there are no ther struct res located on this prop ty except
aseeitl
Owner or Agent 01 t I—) .44 .
Date t*, Pi
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
(9 A DO NOT WRITE BELOW THIS LINE V (/
D/
Tour street address will be 4. J t 7/44.--4-849- lP'' Ot
Sewage Permit Number Issued Building Permit
Remarks
The zone is
Receipt /C3 Issued
*A.