1974, 07-16 Permit App: K5255 MHI
a
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
D
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 must conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
NATER. 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 '1a` ddress Phone
Architect Address Phone
ngineer Address -
nntracsMr Address
Descril#ion &YPrope%ty Give gomplete de jcription frorm
DESCRIPTION OF WORK: New _� Addition Remodel Moving Bid 1. Zone 1 Fire Zone
i
Size of Lot � � � Sewage System. ' ''� CF�nstC.onc Br.,etc.) '
Stories 4—Dimensions !;L 'yo al Sq. Ft. 1��Valuation/5 Li 0 t'
N'1K r
Rooms Baths Basement Foundation Const.. himney Fireplace
F II, part, none►— _ (Kind) (Numb
Heat. System Type rof Roofing Xt. Finish Int. Wall Finish
Use of Bldg. L^ --j) Ci_ 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 State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
i r• m Heating Permit
Sewage Permit
N Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I her y certify information switted is correct and there are no other structures located on this property except
s shown
/ Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT M4ST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be 14 V S The zone is/ ? �A
Sewage Permit Number Issued Bui ing Pe mit l '- 'Receipt /'/ ! Issued' 7 f ', t
Remarks
T
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Form 523 Bldg. Code