1976, 06-02 Permit App: L4391 PoolCtntY Spokane, of S , Wase9 ton
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.
NATER. 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 1.11ft
Name of Owne Address Phon��� '
Architect Address Phone
Engineer 43 Address ���/� 3l "s5'� Phone
Contractor �`�41z`d 't CN( `s Address +T�� Phone 3 5
Legal Description of PrLoperty/ (G v�-/q�}_'!'complete/ description from deed,, tax receipt, etc.) -41
T -fl. �. J I +i '" L •`-� `•+'il J/ ��I Ail � �t_VT�.I! '�L-. ' -•H�lJ
DESCRIPTION OF WORK: New ✓ Addition Remodel Moving Bldg. Zone Fire Zone T—
Size of Lot Sewage System onst. —
/ c Pr-. Conc., r., etc.)
Stories Dimensions �/ Total Sq. Ft. r '�� Valuatio
Rooms Baths BasementFoundation Const. Chimney Fireplace
Full, part, nonce— (Kind) (Number
Heat. System Typeof BQofing Ext. Finish Int. Wall Finish
Use of Bldg._ ,.f r,�� i ),, _ I No. of Units_ Bedrooms
V PLOT PLAN
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 supply lines.
M
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of
Rio
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NORTH RESIDENTIAL — COMMERCIAL
SOUTH
State License No.
_/4
Ind. Ins. Acct. No.
•r
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby ce ify informations m -t -;ted is correct and there are no other structure located on this property except
as showh� � G � ,
Owner or Agent ate
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
Your street address will be ` �' The zone is��
Sewage Permit Number Issued Building Permit Receipt slued
Remarks ,
Form 523 Bldg. Code