1978, 02-09 Permit App: M4868 Residencer-�
0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE '
tte
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 •lth 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 LINE
Name of Owner
Architect
Address
Address Phone
o(.
one ej�?�-o%Y%Z
Engineer Address Phone
Contractor Address Phone
Legal Descrip ion of Property Wive complete descripti from deed, tax re t, tc) Parcel mer
L, o7- «� / oe k3�
112DAOW4yl 10.0 b0r Lt-(��/ -u
DESCRIPTION ON WORK: New %( Addition
Size of Lot }/1/I r 11-.0 l n:
Stories S Dimensi
Rooms (G Baths Basement
Full. part, no
Heat. System £P -Re ((// Z
Ty
Use of Bldg.>4.y111.c%
i'
. # cgvd-2- 9066 >< 9067
Remodel Moving Bldg Zone / Fire Zon10e
1,on\. 9
Sewage System J Const./
02a ,Q h' TotalotSq Ft
unda on Const P.e�.r-t Chimn
Ext Finish Ll/`9-i-A
/%/.7 .� C -.L) y- 2 ,..)
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-
Type 000fing --jyZ-
6
ti
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
m
In
H
NORTH
(Kind eplace --
(Number , l
Int Wall Finish
No of Units/Bedroom
SOUTH
(2)0-
1
aws
Ind. Ins. Acct. No.
RESIDENTIAL -COMMERCIAL
EQUIR
Plumbing Permit
Heating Permit
Sewage Permit
D
Jr
i
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
hI1 hereby certify info ion submittee' is corrects nd there are n ether structures located on this pr perty except
aBeU1`t / . - L.cf. yl .2 /-f-a-} 9/2 Lcrl`iL na) c�19/2P
Omer or Agent
A LA USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE
THIS 1S NOT A PERMIT.
Date
CONSTRUCTION COMMENCES.
�Ae DO NOT WRITE BELOW THIS LINE C�6(
Tour street address will be c. /it./ 7 ,nip-y�p�L¢. /f /) The zone is.�./M,/4[� •-Y-:r vK.�.tt-d.�--
Sewage Permit Number Issued Building Permitf % Receipt /1/O.Issued
Remarks
Form 523 Bldg. Code
2072
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