1977, 08-09 Permit App: M1793 Residenceie Dept.
oae my of Spokane, Washington
•' LDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
- y--- PLICATION FOR LAND USE OR STRUCTURE PERMIT • (5p
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. Nater 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.
1, 1_ _ _ __ ) APPLICANT FILL IN BELOW THIS LINE 199'2d14
Name of Owner Address's
Architect Address
Engineer Address
Contractor Address
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
Phone
Phone
Phone
1166:5Q
Parcel Number 1166:5Q�QQ
DESCRIPTION OF WO K- New tion Remodel Moving BI g. ne Fe _
Size of Lot Sewage Syste �onstt
Br., etc.) p6
Storiesi-AleathaBasemerit'
Dimensions Total Sq. Ft. a
Rooms Foundation onst. Chimney (Kinirep c Heat. SystemTye RoofingExt. Finish �� i� Int. Wall Finish
Use of Bldg. e No. of Units6Bedrooms
P 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 SUDDly lines.
a �
0 30 0
45
�3L
SOUTH
I I hereby certify ie
ormation submit
td correct
as shown.
Owner or Agent
A LAND USE OR STRUCTURE PERMIT M
THIS IS NOT A PERMIT.
Your street address will be _A-0,
Sewage Permit Number Issued
Remarks
Form 523 Bldg. Code
State L se No.
Ind. Ins. cct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
are no other structures located on This„ property except
7 Date 1
THE PREMISES BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS
Building
VV'-
The zone is
Receipt 41 sued