1976, 10-26 Permit App: L5976 Residence5 $
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT oa
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
Hijhlway, clearance must be obtained from the County Engineer and/or State Highway Department. F
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit.
tRESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running with the le►pd
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedicationSe'.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner 1 `f- 4 S J O C_ Address hone
Architect Address Phone
Engineer Address Phone
Contractor /Yl L— Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.)
DESCRIPTION OF WORK: New_n5_ Addition Remodel Moving Bldg. Zone Fire Zone
Size of Lot k i PArE7- A'61,c/ C G Sewage System1 _ onst.
ete4 G VX176Z_ Fr., Conc., Br., etc.)
StoriesDimensions s V x Y X :;L 2-- Total Sq. Ft. Z12V Valuation x:47
Rooms Baths '7-' Basement / Foundation Const.''r�'�.E'L ix- Chimney Fireplace
Full, part, none (Kind) (Number
Heat. System].,/ BLL Type of Roofing -t'hflXC_ Ext. Finish Int. Wall Finish 2d4l, A
Use of Bldg. i /_;v "" c WX7,ov = No. of Units _ Bedr oms -�
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-
tpm and mater sunnly lines_
SOUTH
M
a
N
State License No.
JV
Ind. I ct. No.
REQUIRED
Plumbing PermitTl��K��
Heating Permit Ad
Sewage Permit.
Plans Received _
Plans Checked _
Plans Returned.
Plans Picked Up
Plans Mailed _
I hereby�e fy information submitted is correct and there are no other structures located on this property except
as shown. /"�1 '1/ 11 ,
Owner or Agent flate
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.
Remarks
Form 523 Bldg. Code