1978, 02-09 Permit App: M4867 Residence- County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE' PERMIT
PENE N E R A L R E Q U I R E M E N T S PERMIT FEE .___.__.l __.____.:11
T REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of an
kind or alter any building or structure already erected, or to change a land use. Construction must conform with th
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
NATER. Rater 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 47235.
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 thestructure 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 he
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 rutin Ing with the land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BEI.OW THIS LINE_
Name of Owner w Addressn7 �?/:2 /dills% PhoneL� Z�
Architect Address Phone
Engineer Address Phone
Contractor [lr__y7 .e Address Phone
Legal qesai on of Property, ' e pomplete c�tption frRm deed, tax r eipt, tc 1 .Parcel er
DESCRIPTION OF WORK: rNew y/�. _� dititln Remodel Moving ^ Bid Zone ..._� Fir Zo e
Size of Lot ZQ X�/ Sewage System Const.
�e � Fr., Co n, etc.)
Stories Dimensions p7� o? X .7 �/ oral Sq. Ft. � Valuati1948219-60. ko
Rooms Baths Basement oundation Const.. Chimney lace(—
I F I, pert, n I ind) (Number
Heat. System �F/ Ty a o 4pfing Ext. Finish --int . Wall
Use of Bldgm' No. of Units/.Bedroom
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.
w
N
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NORTH state
SOUTH
Ind. Ins. Acct. No.
—RESIDENTIAL— OMMERCIAL
Plumbing Permit
ra Heating Permit
wSewage Permit _
N
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
submitted is correct aqd there are no other structure$ located on this roperty except
v r—or iu�r o. - io
Owner Agent Date
A LAN USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1 NOT A PERMIT.
Your street address will be
Vewage Permit Number
Remarks
Form 523 Bldg. Code
DO NOT WRITE BELOW THIS LINE
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0 The zone is .�(,J IMI�7/1�vN
Issued Building Permit ReceiptCJ,/�_ Issued A
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