1978, 02-14 Permit App: M4856 Residence•
County of Spokane, Washington
BUILDING CODES DEPARTMENT. N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT h1 1
PERMIT FEE ff
GENERAL REQUIREMENTS
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
A -the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Offices, "a.
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 OO
AddressPhone
Architect _ Address cril/%Q(p Phone
Engineer Address
Phone
•
Name of OwnerAf r,e4 eL t -O
Contractor - Address �. Phone
Legal Des p of Property (Give�com�plee description fffrom deed, tax receipt, etccl.) Parcel N�ulmber .-7Q -j q-
0
DESCRIPTION OF WORK: New Addition
Size of LAt
Stori
Rooms
Remodel
Heat. System
Use of Bldg.
Dimensions
a C$ G Ci Total Sq Ft ie Q O Valuation O e
Moving Bldg. Zone L Fire e J
FF .1
Sewage System S'4' onst.
, C c., r., e 1
)C
Bathe (FuIIIBpart nombl Foundation Const `-r-f> Chimney w�'nd) ' Fireplace
''' ,,,///��, (Ki(Number
Type of Roofing(' ten/ Ext. Finish f -
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street oroad 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.
Int Wall Finish
No of Units .Bedrooms
NORTH
gAt p
SOUTH
w
N
y
S_ 2p,License No.
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 certify information submitted is correct and there are no other structures located on this property except
as shown. '\ n a n I
1/4
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
nits is NOTA PERMIT.
0 V NW° CD �l DO NOT WRITE BELOW THIS LINE
Your street address w111 be /4 5 t9 a d ' r1 ' 1 �� The zone is
Sewage Permit Number Issued Buil
Remarks
(�. Sa' vim'
ng Permit Receipt 6 d
•
712 r
✓ ��
Form 523 Bldg. Code
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