1978, 02-24 Permit App: M4974 RemodelCounty of Spokane, Washington IL
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT�/�y 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.
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 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 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 OP 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 0 OPja-' Address le, .91 r Phone C— _ 6117
Architect Address Phone
Engineer Address Phone
Contractor �r.cti C Address T 3 �d A I2 Phone — S'/ 2
Legal Description of Property (Give complete description from deed, to ec etc.) arcel Num r
ice.,s e
ROADWAY RV�V�RNTNOF WORK: New A
DESC/RI T ilion Remodel Moving BIS Zone Fire Zone
Size of Lot /y' Sewage System og�'r//T �Y+onst.
i 1Fr., Conc., Br., etc.)
Stories Dimensions X-0Total Sq. Ft.I `Valuation � -S—oa ¢-_
Rooms BathsBasemen � Foundation Const.. Chimney Fireplace
Fu 1, part, n (Kind) (Number
Heat. System l ^ �► Type of Roofing Ext. Finish Int. Wall Finish
Use of Bldg. i/1i: .r.-9 /� 4 S C No. of Units Bedrooms
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
Sta a License No.
�C" ,/ e-
Ind. Ins. Acc . No.
RESIDENTIAL COMMERCIAL
REQUIRED
Plumbing Permit
M Heating Permit
30
fA
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby certify information submitted is correct and there are no other structures located on this property except
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
Remarks
Form 523 Bldg. Code
DO NOT WRITE BELOW THIS LINE
Issued Building Permit
The zone is - SJ /'
Receipt O 301f Issued