1978, 03-06 Permit App: M5196 Garage• 1
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT tr0
GENERAL REQUIREMENTS PERMIT FEE id
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 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.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner -. Address ci �'� �'k'!!�ti['. ,� ��� Phone
Architect Address Phone
Engineer Address �+ CA - Phone
Contractor /? e , �A, Address %�' AT C t+ Phone �if
n 7
Legall escripti of Property (Give complete description from dee tax receipt, etc.)
Parcel
/lumbberr
OAD'WAY R/W WIDTH
DESCRIPTION OF WORK: New Addition )( Remodel
Size of Lot 865)K /30
Stories L Dimensions
Rooms / Baths Basement
Fu I, part, none)
Heat. System Rogfing
Use of Bldg. S
02r d-
Moving BId . Zone ____,,Z.— Fire Zone
Sewage System Const. C. %
lFr.o�""�nc..`BBr., etc.) G.45
Total Sq. Ft57"' Valuation 7 �� ��
Foundation Const. .44 ChimneyFireplace
? / (Kind) (Number
Ext. Finish/ �f! Int. Wall Finish
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
1
in
NORTH
GZ'ate}x
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
No. of Units�Bedr6oms
rc 26'
I hereby certify
as shown.
SOUTH
eritted is correc„t?'and there are no
ner or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS IS NOT A PERMIT.
State License No.
SC -/,R -oR-r4 a3J
Ind. Ins. Acct. No.
RESIDENTIAL — COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
other structures
DO NOT WRITE BELOW THIS LINE
Tour street address will be g"—' go 4 I14
Sewage Permit Number Issued Building Perm
Remarks
located on this property except
A-
- 7�
Date
CONSTRUCTION COMMENCES.
The zone is
Receipt0Y6 Issued
Form 523 Bldg. Code