1975, 05-12 Permit App: L0167 Fire Damage Repair• •
County 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 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
ao
Name of Owne
Architect
Engineer
Contractor
Address
Address
Address
Address
<75;-'
Legal D cription of Property iv c plete description from deed ax recd pt, etc)
1/
Phone
Phone
Phone
Phone '? 2- — 3 J
DESCRIPTION OF WORK: New
Addition
Remodel
Moving B;e. 9
Size of Lot Sewage System
Stories
Rooms
ystem
Use of Bldg.
imensi
Baths
3c
asement Foundation Const
part, none) . -
.•
Type of R..fing '" i.., 'xt. Finish
ice/
c Q
�F JConc., Br., etc.)
Total Sq.�� Valuation
��/ CFiimney Fireple �
• (Number I%
PLOT PLAN
(Kind)
Int. Wall Finish
No. of Units _ Bedr
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-
and water supply lines.
0
NORTH
ESIDEAL — COMMERCIAL
c(7 • - "_
SOUTH
State License No.
4.z 3--o) irk/'/
Ind. Ins. Acct. No.
12PS De, 7,S7
REQUIRED
Plumbing Permit 7
m Heating Permit r7-21,/
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby :e tify infor :tion submitted is rf t 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 `PHE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit N
Remar
DO NOT WRITE BELOW THIS LINE
e
Air Issued Build sg Permit
"MOW W
The zone i
Receipt
Form 523 Bldg. Code