1978, 07-12 Permit App: M7267 replaces M0522 Duplex• •
County of Spokane, Washington
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 mil
kind or alter any building or structure already erected, or to change a land use. Construction mast 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.
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APPLICANT FILL IN BELOW THIS LINE
Name of Owner
Architect
Address
Address
Engineer Address
Contractor Address
Legal Description of Property (Give complete description from deed, tax receipt. etc.) Parcel Number
3-
Phone 77? - ,`J
Yg_ge, `s�er�'e- 2 dPhone
835 Phone
/e)ceL,-
lone
aG5 /3 -90 2 7
/
ROADWAY R/W WIDTH
DESCRIPTION OF WORK: New X Addition
�D X /3-5
Size of Lot
Stories 5/'/'Dirfensions
Rooms 5 �G
Heat. System
Use of Bldg.
Remodel
Moving
Sewage System
.ge9
s Basement Foundation Const
Fu I, part, n
Total Sq
Bldg. Zones F
S /
(Fr., Conc., r. etc.)
. Ft. 3a.6-,4 Valuation t'"dO��no
Chimney - Fireplace /-'
( ind) (Number
Int. Wall Finish /c/i-e----e--/
• e Zone
�=L, rr- Type of Roofing Ext. Finish /.(�
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
m
iA
NORTH
No. of Units—Bedr
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
� �e_e_. `731 05 as
SOUTH
State License No.
Ind. Ins. Acct. No.
TI COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
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
as shown.
X
Owner or Agent
7///7
Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
/30 g --/D
Your street address will be
Sewage Permit Number Issued
Remarks
Building Permit
The zone is ci %'
} n Receipt q r3/ Issued
7-47
Form 523 Bldg. Code