1978, 11-20 Permit App: N1591 Residence, Renewal of M5017 County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 /t
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 1 d
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 dr��/ �� Address A `rte_J Phone 772 .5�-�
Architect I Address i_ _ -IP" Phone
Engineer Address 1 Phone
Contractor Address -3 i Phone
Legal Description of Property ( ive complete/d��.c,{cripti n f d d, tax receipt, etc.) Parc!) Number c? '/5-5'-3-� CC
S7Y
DESCRIPTION OF WORK: New X Addition Remodel Moving BId . one _1_ Fire Zone .1
Size of Lot AZ�. x 26P Sewage System �FrnsCono„ Br., etc.) roc
tori s bans /.. ,' f( Y..? ^ Total Sq. Ft. /" Valuation -rte Q
Rooms 0 Baths Basement Foundation Const. (//� 1 Chimney Fireplace
t� (Full, part, none , -y-- (Kind) (Number
Heat. System t .--9,-,5 Type of Roofing / Ext. Finish / —/// Int. Wall Finish Z
Use of Bldg. �yr..� 4-C I,cs-&_Z ' 4�.�.� No. of Units Bedrooms
( k,c) PLOT PLAN
Draw sketc11:6A-)
w th dimensions showing: (1) property lines; (2) street or road locations; (3) location of exist ng
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sew e sys-
tem and water supply lines.
1 NORTH State License No.
_
Ind. Ins. Acct. No.
-ESIDENTIAL-COMMERCIAL
AOOF
*6-o / 7 REQUIRED
Plumbing Permit/��
m Heating Permit`'. A.
m
iA tn Sewage Permit L".nr i
-I -I
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereby certif nfo mation submitted is correct and there are no other structures located on this property except
as shown. ..
11-771 , Z J/yea -Jp-- N..
ner or Agent Date
A LAND US-Ailw STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NO A PERMIT.
, "1/41 .#.4DO NOT WRITE BELOW THIS LINE
-
Tour street address will be i //e) ? ,�t !` `'� _ s The zone is. 9 .'_A,. 1 - -`nn '
Sewage Permit Number Issued / Building Permit Receipt 4 ' as ed ,
Remarks Cl 9_442I
�� � III
Form 523 Bldg. Code
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