1978, 04-03 Permit App: M5548 ShopCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of aqy
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.
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 / w( 14 Address
Architect '. Address
Phone
Engineer .."` Address Phone
Contractor L. C.— Address Pho e_
Legal Description of Property (Give complete description from deed, tax
receipt, etc ) / P4 kil.t,
/P1C{r`k 2±/6 yY 021 /
e-,t4L Qf ol `h� 1 2._ / Li L r /i_,,
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Phone t 1 V
its i ! st G/ ;t f II
-
DESCRIPTION OF WORK: New - Addition
Size of Lot q ,4 2'11
Remodel
Moving
Sewage System •
Stories ___Dimensions
30 a1a0�
Bldg. Zone / FireZone
• Const. 4?/6-1v211,/
(Fr., Conc., Br., etc.)
Total Sq. Ft 6 cry Valuation j S -4Z0
Chimney 041,1f' Fireplace
(Kind) (Number
Int. Wall Finish
No. of Units Bedrooms
Rooms ` Baths Basement
(Full, part, none)
Heat. System Type of Roofing Cts
Use of Bldg. V A
Foundation Const
C. rsUei�.�l!
Ext. Finish
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations;
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings
tem and water supply lines.
rn
1
NORTH
rie-t Gatada
SOUTH
fti
1
(3) location of existing and
; (6) location of sewage sys-
State License No,
1
0-1-114-s 0-A3330
Ind, Ins. Acct. No.
REQUIRED
/ A,
Plumbing Permit
Heating Permit
Sewage Permit c--
t,
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans
Maijed
I hereby cert.,ify information su mitted is correct and there are no other structures located on this property except
> . rn 4 /5 /7R
Owner Agent Date
A LAND USE OR T PURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
as shown.
DO NOT WRITE BELOW THIS LINE
Building Per
C/
/ / I
The zone i
Your street address will be
Sewage Permit Number Issued
Remarks
Receipt /
ssued
Form 523 Bldg. Code
J
1
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