1978, 03-06 Permit App: M5144 replaces M2171 ResidenceCo tY of Spokane. WashOgton
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 47235.
SETBACK 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
Name of Owner Andrew :'•:. Term-_ Address 1 L Y� erG �rast _Phone='24-97SO
Architect Address Phone
Engineer Address Phone
Contractor Andre- K. Terri 'o:ltractinp: Address B;)X 14902 - J G"� vera vS��g S2'-)- ,73, o
Legal Description of Property (Give complete description from deed, tax receipt, etc.) -�
Let 1f Rloc=: 7 Rotc;-_ford Here-_ tracts 112 .3hamrcck
DESCRIPTION OF WORK: New X Addition Remodel Moving Bldg. Zone 1 Fire Zone
c t 2,7 t r1 t ' 7t Sewage System ne 1' ^ onst. rr�P
Size of Lot 1 X x ;L7 x -
/ � �Fr., Conc.,�r., etc.)
Stories 1 Dimensions 26 t x �1 t ,� �'�2�/ /4 �� 1 i( 1Z Total Sq. Ft. Valuation �'>, GLL. �v
Rooms 7 Baths^ Basement ��rt�� Foundation Const. coacre L`= Chimney � e �� Fireplace
Full, part, nonce (Kind) (Number
Heat. System Fr_ Type of Roofing rP 'r. Ext. Finish n -i- r Int. Wall Finish '-2 .?-11
Use of Bldg. =i n^e :ith do—Bbl br rr� �;e un der_ 22 x 24 No. of Units Bedrooms T-
6�L�il P/&) 6d r PLOT PLAN
Draw ske h 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 SUDDly lines.
a
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NORTH RESIDENTIAL - COMMERCIAL
1,v `4 -2 / V
SOUTH
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
M Heating Permit
N
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
certify i or mitted 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 1� NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
��You�street address will be South
Sewage Permit Number Issued
Remarks
Form 523 Bldg. Code
Building Permit
The zone is
_ Receipt OvsY Issued
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