1977, 08-02 Permit App: M2660 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 0
GENERAL REQUIREMENTS PERMIT FEE �f
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.
r 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 ddress
Architect Phone Engineer
Contractor Address
Legal Descr' tion of Pr rty (Give complete scripti n
A-- I a 1e *-.‘t k.
V
DESCRIPTION OF WtK:.N w! Addition
Size of Lot JJ��
Const '� imensions 10A 2 A a
lz
Phone
Phone
Phone
from iked, tax receipte,K__�
aur 'n�
�rs
Remodel Moving Bl Zone / Fire Zone
Sewage System (44 f (, StorlA
Total Sq. Ft 6 Cs Valuation 1'
C0-�c 111
(Frame, cohere e, br'cif,'etc.)
Rooms Baths 1
BasementIF: Foundation Const
(Full, part, none) Ca
Heat. System Tyof Roofing
Use of Bldg.
�arag�r Carpor
f
Ext Finish"
Q C ��C. e4
Q
Chimney Y 1 vl ejFireplace r
(Kind) (Nurriber)
Int. Wall Finish
No. of Units 1 Bedrooms
Private Detatched
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.
NORTH
I here certify
as shown.
SOUTH
on witted is correct
Owner or Agent
and there
State License No.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit
rn Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
are no other structures located on this property except
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
Go
Your street address will t� `
S
Sewage Permit Number Issued
Remarks
e zone is /C,
Buil. ng Permit Receipt Issued
Form 523 Bldg. Code
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G.rre:ti'-:ns mace by HUD on these document=
be construed as necessarily provfid
1 ry f:.il cc- e.1piiance with HUD Minimum Proper
Statara; ds. It is the sole responsibility of the
builder to fully comply with MPS require
07.V.1 ents as administered by the local HUD/FH)
office.
NOTE