1976, 05-10 Permit App: L3725 ResidenceCCntY Spokane, of S , Wase9 ton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 U
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 4vO
GENERAL REQUIREMENTS PERMIT FEE q
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 must 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.
f
APPLICANT FILL IN BELOW THIS LINE
Name of Owner - j� Address' Phone
- o
Architect ._ _ r ,11 Address
Engineer Address
Contractor.." _C Address
Legal�D�`S�crJ,ption of Property (Give
co lete description from deed, tax .receip , tc..))
-
one
DESCRIPTION OF WORK;., New
r
Size of Lot
2i
Addition Remodel
Moving
Sewage System
Stories / Dimensions ,-
s
Baths Basement Foundation Const
`A (Full, part, none) t" J--.
eat.. Systdm Tempe /1 of Roofing �- � --9 7-3 Ext. Finish /
BIdZone/ Fire Zone
Const.
(Fr., C. Br., etc.)
Total Sq. Ft -' G e ° Valuati .n -"35 /S. 2)/C--
Chimney Fireplace(Nu/
(Kind) mb
Int. Wall Finish
No. of Units_ Bedrooms 3'
Use of Bldg.
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.
to
NORTH
RESIDENTAtr - COMMERCIAL
SOUTH
I hereby ce tjjy informati submitted is correct
as shown. X
and there
m
State Lic se No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Perrr�` " c�'r- rf.�-�•~ �--
Heating Permit 2 -
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
•
t '
are no other structures located on this property except
3 -z
Owner or Agent
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT PERMIT.
DO NOT WRITE BELOW THIS LINE
Tour street address will be
i
Sewage Permit Number Issued
Building Perm
The zone is
j. Receipt`s' ,e' sued
Remarks
Form 523 Bldg. Code
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