1977, 02-14 Permit App: l6928 MHCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT.,,,. -
GENERAL REQUIREMENTS PERMIT
FEtMIF 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 witl1the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection. /k
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 X ^2 /Lt -Z- " Address
Architect Address
Engineer Address
Contractori +� ` u" `' 't 1 AddreA
Legal De§griptionllf Property.4Give c(*npl4te description. from deed, tax
�1U
Phone
Phone
Phone
DESCRIPTION OF WORK: New Addition Remodel Moving Bldcl. Zone_— Fire Zone -7
Size of Lot -;?1-5 1� � Sewage System-. Const.
Fr., Conc., Br., etc.)
Stories Dimensions Y To al Sq. Ft. l6 Valuation r io•�CTO C l
Rooms �_ Baths Basement r Foundation Const. -� "Chimney _LL 1� Fireplace —(1—
ul 16
part, none)'- -^ (Kind) Jfy7 (Numbers
Heat. System �� -Type of Roofing 1 -z -L e+ Ex Finish �� " Int. Wall Finish
Use of Bldg. _,7 =� � e- No. of Units Bedrooms
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.
NORTH State License No.
Ind. Ins. Acct. No.
77
REQUIRED
`f�_ f Plumbing Permit
r m Heating Permit
to 4A�' -�� L Sewage Permit
ajjJ '—
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby cgxtify information submitted is correct and there are no other structures to ted on this property except
as shown. J
(� ner or Agent Date
A LAND USE OR STRUCTURE PERMIT l U BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS-iMOT-A PERMIT. v
DO NOT WRITE BELOW THIS LINE
Your street address will be G /��- zone iso -v'=^
Sewage Permit Number Issued Buil g Permit ceipt �2 Issued
Remarks
Form 523 Bldg. Code
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