1978, 05-03 Permit App: M6161 Remodelft
•
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT/ a�
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 J4=y�, ZC-Vr-Z0,1
Name of Owner
Architect
Engineer
Contractor _
Legal Description of
(Give
Address ,.�• 9� /�e&*=Z Phone
Address Phone
Address Phone
Address[ 6,:2,2 % x/107 Phoned—� ' i
description from deed, tax receipt, etc.) Parcel Number ef 5` .413 ' 0//,?
ROADWAY R/W W10 Fire Zone
DESCRIPTION WORK: New Addition Remodel Moving Bldg. Zon
Size of Lot ZLO /.2 n Sewage System L� ,� insConc., Br., etc.)
Stories ,,� Dimensions %`/ Total Sq. Ft. L](Vd Valuation J�0
Rooms &A Baths #4 Basement N-4 Foundation Const. �/� Chimney � Fireplace
Fu I, part, nonel (Kind) (Number
Heat. System Type of Roofing Fxt. Finish Int. Wall Finish N14
Use of Bldg. No. of Units Bedrooms
PLAN
Draw sketA�wheiml,�niions Mowing:(1) property lines; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines acd streets; (5) dimensions of buildings; (6) location of sewage sys-
tem and water supply lines.
UZI
NORTH
SOU TH
State License No.
a. K.
Ind. Ins. Acct. No.
RESIDENTIAL — COMMERCIAL
REQUIRED
Plumbing Permit
rw Heating Permit
HSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
S/"1/%9
I hereby der Unformation submi d r ct and there are no other structures lgcated on this property except
as shown.
�`' 3 /r
OwnerAr Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be _ �Sl: �f S'~ %a-*# " The zone is
Sewage Permit Number Issued Building Permit? Receipt Issued
Remarks
Form 523 Bldg. Code