1977, 07-11 Permit App: M2298 PoolCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
r,
GENERAL REQUIREMENTS PERMIT FEE _____________ ----
PEWIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or struct re of any
kind or alter any building or structure already erected, or to change a land use. Construction mast 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.
SETBACK 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 LINE
` _���drif✓
Name of Ownerx ,r
Address
'�_ Phone.2.v 6 ' �3
Architect
Address
Q'��`,i' Phone
Engineer
Address
Phone
Contractor
Address
Phone
Le al Description of Pro rty ( ive omple descripti
from de d, tax receipt, etc.) Parcel Number
3
DESCRIPTION OF WORK: New Addition
Remodel
Moving Bldg. Zone Fire Zone _
Size of Loth X /
Sewage System/� s� onst.
�Fr., C
r
nc.,
Stories Dimensions 1,6, 3 "
Total Sq. Ft.�'� valuatio
Rooms---$aths --- Basement ` Foundation Const..
Fu I, part, none►—
Chimney Fireplace
(Kind) (Number
Heat. System Type o Roofi .
E
finish Int. Wall Finish
Use of Bldg..
Z7 No. of Units Bedrooms
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.
NORTHState
License No.
SOUTH
Ind. Ins. Acct. No.
RESIDENTIAL — COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby ce34�ify information s bmitted is correct and there are no other structures ated on this property except
as shown. /I _ .4 J* � /
V — Owner or Agent D e
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be��
Sewage Permit Number Issued
Remarks
Form 523 Bldg. Code
DO NOT WRITE BELOW THIS LINE
Building plErmit
The zone is i//.1, �o ice/4
Receipt 0, ( I issued