1978, 08-02 Permit App: N0021 Replaces M5173 Residence0 4
CAnty of Spokane, Wasagton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT "
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 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 ,ry
Name of Owner / Y Address Phone -77:2
Architect Addresshi" aO 2eAA1_-N_ . r d-, Phone
Engineer Address 4Ex,?_r- Phone
Contractor Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
DESCRIPTION OF WORK: New _X Addition Remodel Moving Bid . Zone ` Fire Zo
Size Lot � � ,A' 1.2�% Sewage System 'G Const.
L
/ �'T e0 L( Fr., Conc., r., etc.I MI h
Storie� Dimensions Total Sq. Ft. Valuation "g
Rooms Baths Basement Foundation Const. aWe— w' e �� Chimney Kip Fireplace
Full, part, none ((�� qq (Kind) (Number
Heat. System Type of Roofing rJ I�f A X e--- Ext. Finish &�o tI D Int. Wall Finish
Use of Bldg. //0 9-77- FtCss e.d j /2121 9 e --No. of Units /_ Bedrooms,
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) locatioi-of—ftisting 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 SIDE COMMERCIAL State Lice se No.
tV, Z9
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit 11"IT 13
m Heating Permit W1,6ew/rQe12T—
HSewage Permit l g,'g—it�l
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
8%7Q
SOU TH (/44W
I hereby certify inf tion su tted is correct and there are no other structures located on this property except-,.
as shown.
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT "ITE BELOW THIS LINE!
Your street address will be / The zone is 1<2
Sewage Permit Number Issued wilding Permit Y11,11 I Receipt S/ #� Issued
Remarks
Form 523 Bldg. Code
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