1976, 07-12 Permit App: L4655 Addition•
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County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 J,
APPLICATION FOR LAND USE OR STRUCTURE PERMIT! i
PERMIT FEE I
REQUIREMENTS
GENERALD________________
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.
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 cs�Address - Phone
Architect Address Phone
Engineer Address Phone
g rwv
Contractor `tom C ' ' Address -11 f -10 Phone
L I Description operty ive comple descrip ion from deed, tax recet, etc.)
DESCRIPTION OF WORK:: New Addition Remodel Moving Bldg. Zone _t Fire one
Size of Lot 10 r ` I f Sewage System �y+onst.
1Fr., C c., Br., etc.) \L
Stories / Dimensions _Total Sq. Ft. U Valuation "
Rooms 1_ BathsBasement Foundation Const. .�� d L,� Chimney Fireplace \\\
Full, part, noneT— (Kind) (Number
Heat. System Type of Roofing Ext. Finish Int. Wall Finish
Use of Bldg. 49_,:Z, J-;;4 ; No. of Units —Bedrooms
i
PLOT PLAN"
Draw sketch with dimensions showing: (1) property lines; (2) street o4 oad locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6 ocation of sewage sys-
tem and water supply lines. x
NORTH / RESIDENTIAL —
i_. ,. i i
SOUTH
ERCIAL State Licens N
Ind. Ins. Ct. No.
REQUIRED ZJ 5A,3U 3
3—L l -Svac+
Plumbing Permit
M Heating Permit //
30N
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I herepy cc
�rt�fy informat34h s_ ted is correct and there are no other structures located ori this property except
as snownli
( / Owner or (Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
11 / DO OT WRITE BELOW THIS LINE
Your street address will b ! The zone is -�
Sewage Permit Number Issued ilding P r it `� Receipt)? r ? Issued `
Remarks
Form 523 Blda. Code