1978, 01-05 Permit App: M4532 Residence, Renewal of M0621 County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
4.12
GENERAL REQUIREMENTS PERMIT FEE 1./ .'
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. 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 ✓r _ - Address I'i s� ,4 Phone 2 . -'5-75-11—
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A'ir.
Architect Address mac. r C ti Phone
Engineer Address F_y„P 3,5-- Phone
Contractor rv.c, Address Phone
Legal De rip ion of Property (Gve co plete description fro eed tax receipt, tc.)
g-) -,-,-c•_<_, 024/.5 i/.? — 601 6
DESCRIPTION OF WORK: New X Addition Remodel Moving Bldg; Zone I Fire Zone
Size5f Lot '-c >/ `e,0 Sewage System . Const. �K'
C :
(Fr., onc.--Br.,etc.)
S s Dimensions _'`-1 X. -.'y Total Sq. Ft. /'2'7/ �? ..% ,
f Valuation
Rooms !r Baths -� Basement �.. / Foundation Const. �7..02--:./„:"-,,,..,2:fChimney " Fireplace L vf�
� (Full, part, none) ( m d) (Numb-
Heat. System ear /• . Type of,�Roofing� c3 4 -w.. .. Ext. Finish i✓=rae.Dd Int. Wall Finish 2C2--,- ---,‘"
Use of Bldg. ,e--,..0 -, .e 2z:ry X� „«„„ L Bedrooms
No. of Units -»
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 an.ter supply lines.
NORTH 'ESID -
OMMERCIAL State Li en o.
Ind. Ins. Acct. No.
REQUIRED
Plumbing Permit 7:-.1.
,
- m Heating Permit / 7�/e �/�
f`
a in Sewage Permit ( &,lifi�f✓E I✓ I
i .4
e1///// Plans Received 21
�/��
���/ Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I he ertify information submitted is correct and there are no other structures located on this property except
as shown _ j
ii .. if- _yG�
Owner or Agent Date
A L• D USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
ei�2,.-?72.e DO NOT WRITE BELOW THIS LINE
Your street address will be t /,... '7U' I 1/ """ The zone is 4(ti--
��Sewage Permit Number Issued Building Permit
! Receipt � ssued
Remarks
On ---/Wy ___/a , ,
Form 523 Bldg. Code
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