1978, 03-17 Permit App: M5302 Residence• 1
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT y� °✓
GENERAL REQUIREMENTS PERMIT FEE C
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.
APPLICANT FILL IN BELOW THIS LINE p92U 7
Name of Owner Address L / S 3 ��� Phone i/t 4 74.1? - / �.2 4"
Architect Address Phone
Engineer Address Phone
Contractor Address -� Phone
Legal Description of Property (Give complete de cri tion from deed, tax receipt, etc.) P ce Number /1-1--4/.:i --a ! L
a 7/.2 � -
P,CADWAY R/W WIDTH S7l (
DESCRIPTION OF WORK: New V Addition Remodel Moving Bldg. Zone Fire Zone
Size of Lot — ��� )(/ , , r Sewage System SCp%/ G• Const. % 'Qif '�'
qq 6 r f ° p' (Fr., Conc., Br etc.)
Stories Dimensions aC �l S ! �x 2/ + Sx / Total Sq. Ft / ,r' Valuation 43 S 0
Rooms 5- Baths Basement /-v l i Foundation Const a UX C Y . t T� Chimney, C�a / Fireplace
(Full part, none) (Kind) (Number
Heat. System / L -Type of Roofing C -41 -""r -
/
Ext. Finish Tf -f Int. Wall Finish r, ��° `�
Use of Bldg.
or -,-4-----r- t. ---r- No. of Units _Bedrooms
(� PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
Draw sketch with dimensions showing: (1)
posed buildings; (4) distance to property
and water supply lines.
l
d0
NORTH
m
to
°
j o
OL've
SOUTH
I hereby certif info ration submitted
as shown. L,
ersdex
is correct and there are no
fate License
V
o�-
Ind. Ins. Adct. No.
l
RESIDENTIAL
COMMERCIAL
EQUIRED
Plumbing Permit
re Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
3//7/7r -' -
other structures located on this roperty except
- /7- 7
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IWITA PERMIT.
or 3 1 DO �N/O`TWRITEE BBEL%/O�,�W� THIS LINE /
Your �treet address will be E , /5 v ( 9 C9.,.��- A",---' The zone isii, , Ste O•
Sewage Permit Number Issued Building Permit II_ !IL-3 O Z Receipt Ob 9/ Issued
Remarks
Form 523 Bldg. Code