1975, 08-13 Permit App: L1155 RemodelCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 ,fir
APPLICATION FOR LAND USE OR STRUCTURE PERMIT ///`/'
GENERAL REQUIREMENTS PERMIT FEE .1D
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 most 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.
AP LICANT FILL IN BELOW THIS LINE grj11/6
Address / gid Phone / 2 lig 77
Name of Owner P -at-..
Architect
Address Phone
Phone
Contractor lct.'rvtL- Phone
Legal Descripti f Property (Give omnulete description from deed,
Leccigre eipt etc) Q '� s y /- 0 4j// //
Engineer Address
Address --34 --t_.
/'
a
DESCRIPTION OF WORK: New
Addition
Remodel
Moving Bldg. Zone / Fire Z ne 3
ConCst.
r., o •• Br., etc.)
Size of Lot
Stories .L_ Dimensions
a2-
Rooms 7,Z__ BathsFu I, Basementpart,none
Foundation Const
Sewage System
Total Sq /, Ft S/,
QU Valuation �
Heat. System Type of Roofing Ext Finish
Use of BId:, (iJrw .1'Y� / >f-- �C>��/�-✓"'/
raw sketc" with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
m
m
N
NORTH
Chimney Fireplace
(Kind) (Number
Int Wall Finish
No of Units _Bedrooms
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
RESIDENTIAL — COMMERCIAL
tate License// No.
Ind. Ins. Acct. No.
REQUI D
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hereb certify information submitted 1s cor -ct and there are .o other structures located on this property except
naniirewL,
er or Agent Date
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 /So[ / U (yf. cd J The zone is
Sewage Permit Number Issued Building Permitil'/ Receipt a Issued fff
Remarks
Form 523 Bldg. Code