1978, 02-23 Permit App: M5151 RemodelCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 0
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 CountyandState Health Departments. Where workonwater 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. 45-133and 47.235.
SET -RACK FROM PROPERTY LINES. in most zones and under most circumstances, a set -back from the front property line, of at
least 251 is required, a 5side yard, 151 side yard from a flanking street, and a 251 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 66-,;,.41,
Name of Owner 6L Address 1#10r Z -(e Phone
ArchitectAddress c
Phone
Engineer Address Phone
Contractor Address Phone
Legal JDescription of Pr (Give complete d9scrip
tion from deed, tq, receipt, etc.) Parcel Number 0,?,
0 _16
NMI
NOW R/W MUM
DESCRIPTION OF WORK N Remodel .11� Moving— Bldg. do. Zone Fire Zone
Size of Lot1-- onst. Sewage System 4 C_/-.00ed ,3;w
(Fr., Conc., Br etc.) to Q
Stories Dimensio aTota! Sq. Ft, Valuation
Rooms Baths. Basement Foundation Const.
S / /��f Type of I* frog , ng Chimney indl Fireplace
Heat. SystemaInt. Wal Finish OKI Fu 1. part, non I* in
Ext. Finish I ni 54i Ily
Use of Bldg. 1
of Units —Bedroomn _1700pe
N \W - -
Z, 09L- 0AQ0_)f-Z, a�_, /�_,h�_
6 PLOT PLAN 17
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 ^pply lines.
IState License No. T A,_,_, 0� I
/Ind. Ins. Acct. No.
iE-
ESIDENTIA
COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
M
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I herTby cqr.-tffy information correct and there are no other structures ocated on
an mitt d is c eis property except
as show
.2
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERAHT,
DO NOT WRITE BELOW THIS LINE
Your street address will be
.4��2 � The zone is
Sewage Permit -Number Issued Building Permit Pt
6091-4/issued
Remark 611t V Iv
4
Form 523 91dq. Code '/) J -_ -