1977, 07-22 Permit App: M2501 PoolCounty of Spokane, Washington �L
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 992010
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APPLICATION FOR LAND USE OR STRUCTURE PERMIT i
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.
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.
(� c /i APPLICANT FILL IN BELOW THIS LINE
Name of Owner Address v Phone
Architect Address le k2i Phone
Engineer Address Phone
Contractor Address Phone
L I Description 0 P _perty (Give completscri tion from deed, tax receipt, etc.) Parcel Num r 5S
DESCRIPTION OF ORK: New Addition Remodel Moving Bldg. Zone —� Fire Zone
Size of Lot Z 7 2C 6 //.3 Z 414) %L S Sewage System �FrnsConc., Br., etc.)
Stories Dimensions ! !� �` Z Total Sq. Ft. 5ValuationLA 42
Rooms Baths BasementFoundation Const..(--y-,ry-A-t a Chimney Fireplace
F I, part, none -T (Kind) (Number
Heat. System Type of Roofing . Fini Int. Wall Finish
Use of BI g. No. of Units Bedrooms
N1-1/ PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations;
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings;
tem and water supply lines. /,N
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SOUTH
(3) location of existing and
(6) location of sewage sys-
State License No.
IiLnx�Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
M Heating Permit
HSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby cernform�tion ubmitted s correct and there are no other structures located on this property except
shown. n J n _ .. / /
Owned or Agent Date r
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
Form 523 Bldg. Code
DO NOT WRITE BELOW THIS LINE
Issued 1 Building Permit
The zone
Receipt_