1978, 09-09 Permit App: N0523 Residence5,1
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON. SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE._..7
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 BELO THIS LINE
Name of Owner_ RalLiiil Address
Architect Address
Engineer
— Address
Address
Contractor .S erne--•
Legal Description of ro ert (21Give co ete description from deed, taxAmpipt etc.)
I Gf ((/ �/o rK y %no r
PT
Phone arC
Phone
Phone
Phone
1-1
1-
.ROADWAY R/y' w(Oru .t"/)/
DESCRIPTION OF WOO/gK: New Addition.Remodel
Size of Lot tJ X 7 3 7—
Moving Bldg. Zone / Fire Zoneon3
Sewage System 5 Sr'p_-/ C. ponst. i r
IFr.0
, onc., Br., etc.)
StoriesDimensions .. 0 / P. XL7-- C S /7 Total Sq Ft_Valuation,471} D cio
Rooms Baths / Basement y// Foundation Const QmNC -% Chimney / Fireplace '
GIC C7• (Full, part, none ( 1 / (Kind) ,/� (Number
Heat. System �jtlfype of Roofing _ 1 cam/ gExt Fi ish /hi i ej/cr1 N i Int Wall Finish V 7 W 2/ /
Use of Bldg. 1 / ti -CN C� (7 & Cq y QC.!'!K': No of Units,. Bedrodms -
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.
HeRtH tact 4"
y° 22.
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GI Z tan
21-
-
Z.
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EZs+- 991I•TM Mar A) 1*
State License No.
Seel( L6 A317j) L/
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
yy
/1 /2
I hereby tify informat}t5'gt submittftd is correct and there are no other structures located on this property except
as shown.
Owner or Agent
Date
9-I-78
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
0tU MM7 'f n(- 7 DO NOT WRITE BELOW THIS LINE
will be Q-(�_,
Issued Building Permit-'
Your street address
Sewage Permit Number
Remarks
3 /L
The zone is
Receipt
Form 523 Bldg. Code