1978, 04-19 Permit App: M5844 Remodel45111 411
County of Spokane, Washington
BUILDING CODES DEPARTMENT. N. 811 JEFFERSON, SPOKANE, WASHINGTON 9920 •
APPLICATION FOR LAND USE OR STRUCTURE PER T ?&-
GENERAL
&GENERAL REQUIREMENTS PERMIT FEE 3/'
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 onwater 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
�LINE1,
Name of 0 Address t47fl // Phone -22%
Architect Address Phone
Engineer Address Phone
Contractor j - AddressPhone/'S� a
Legal D: seri. ion of Property (Give complete description from deed, tax receipt. et - : reel Number 5, — U /
/—A WA Tar fra I Flo r
/
ROADWAY R/W WIUIH
DESCRIPTION OF WORK: New Addition Remodel
/
Size of Lot ,A /
Stories _/___ Dimensions
2t/" X-2&'
Rooms Baths Basement 0 Foundation Const
Fu 1, part, none
Moving Bld Z ne Firc.E oe e
Sewage System a / ,r Cons �`'/
�j/ Fr., Conccgr.4%),1
Total Sq Ft a��4C/ Valuation.. -1> /�,' �
74 himney 17 Firep ace �y
:/7�/ . (Kind) e
� nt Wall Finis
,•1xatege ei i •'
No of Units 1Bedrooms -"We/
// /
Heat. System
Use of Bldg.
AV
y
Ext ..Eini
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
SOUTH
cfe t 'cense No.
' Ind. Ins. Ac No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
w Heating Permit
Sewage Permit
N
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I her y certify information submitted is correct and there are no other structures loc ted on his property except
as show
/Y Owner or Agent Date
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' Issued
Remarks
00 NOT WRITE BE OW THIS LINE
/i
�rr((//The zone
B• ilding Permit V Receipt
Form 523 Bldg. Code