1977, 02-14 Permit App: L6925 MHCAtY Spokane. okane. Wash#gton
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BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT -
tGENERAL 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 must conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
NATER. Nater 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 o 4 Address Phone
Architect Address Phone
Engineer Address Phone
Contractor411
s Address
DESCRIPTION OF_WO K: New
Size of Lot
Stories Dimensions
Rooms _4 Baths _'i=
Heat. System
Use of Bldg..
(Ow comp
Addition Remodel
Basement Foundation Const..
part, none
ypeof. Roofing I
tax receipt,
— d
Moving Rd— Zonp Fire Zone
Sewage System-- onst.
PFr., Con, Br., etc.)
T tal q. Ft. G
Vi'
�06
z'"Chimney �Fireplace
r
Kind) (Number,-
Finish
Number,
Finish �e- Int. Wall Finish
k' No. of Units L 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 RESIDENTIAL — COMMERCIAL State License No.
Ind. Ins. Acct. No.
��L. - ✓� "�`{ - REQUIRED
Plumbing Permit
1� ' / MHeating Permit
N i v+ Sewage Permit
Plans Received
�C.
/ Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby cer y information sub 'tted is correct and there are no other structur s located on this property except
as shown. 1 4
f Ow r or Agent ate
A LAND -JJ" -ORS RUCTURE PERMIT MUST Bi ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
i
Your street address will be G �' The zone is
Sewage Permit Number Issued Building/Permit Receipt issued
r
Remarks
Form 523 Bldg. Code
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