1978, 05-01 Permit App: M6065 AdditionCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT jj A4
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. (later 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 enfo,rce covenants or dedications.
�C //"APJMCANT FILL IN BELOW THIS,( LINES ,�/0lp/
Name of Owner
Address 3
Architect
Address _
Engineer
Address _
Contractor
Address _
Legal DeAcription of Property (Give complete description fr9W-deed, tax
etc.) Parcel Number
Phone
Phone
Phone
iUAUWAY R/W WIDTH
DESCRIPTION OF ORI New A dition R�model Moving Bid . Zon Fir one
Size of Lot 2 *Z h Sewage System PrnsConc., B t .)
Stories�Dimensions Co Total Sq. Ft.
v_aluation
Rooms Baths Basement' Foundation Const. Chimney Fireplace -Z
F art, none (Kind) (Num r
Heat. System / pe of fin Ex . Fini Int. Wall Finis
Use of Bldg.No. of Units drooms
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. I-Vos /1,
State License No.
�"
Ind. Ins. Acct. No.
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
there are no other structures located on this property except
VL Ais6u1, Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Tour street address will be
Sewage Permit Number
Remarks
Form 523 Bldg. Code
Issued
DO NPT WRITE BELOW THIS LINE
-A
"L The zone
Building Per -It Receipt / Cly ^ rl�i Issued