1978, 03-06 Permit App: M5226 Residence T
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
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GENERAL REQUIREMENTS PERMIT FEE. _g•
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 supplymust be approved by the County and State Health Departments. Where work on water connections disturbs
t surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
SAGE SYSTEM. Permits are required in all cases by County Resolutions Now. 45-133 and 47.235.
SE -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set-back from the front property line of at
le st 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.
A AI APPLICANT FILL IN BELOW THIS LINA ���£ '4 'j
Name of Owner /.1/1/,�u�AWi Address 11P.Of �%%�///- _ 1�I Phone f'' dei 44
Architect ' IF_ Address % / Phone
Engineer Address Phone
Contractor _ Ji/91,4, Address JJP e
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number -� - z i
(1/1e- , -5 --",..J/1/_,A 4Z. 7..dZezy 7iie;ez .d_SLY.o 22-erh
ROADWAY R/W WIDTH tee/
DESCRIPTION OF WORK: NewCA iti // Remodel • Moving Bldg. Zone ( Fire e
Size of Lot X/ (2 '/ '' ��'� Sewage System I`-'9- "Fonsr. Conc. r )
< < /--, . �'' t 'epi
Stories Dimensi s •tal Sq. Ft. Valuation /
Rooms- . Baths F Basement ' F Foundation Const. 1, _ , Chimne Fireplace
/6 / (Kin (Numb
Heat. System �//T'�e o Roofing _ ,�Exxt.rinish Int. Wall Finish
Us: • : .g. /[ �,7JZL %Y//, (--0,_/y/t , �1 /J!,�/� -- .�l No. of UnitsiBedroom �/
PLOT PLAN
Dr Ar sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
prop.-ed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
and water supply lines.
NORTH State License No.
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Ind. Ins. Acct. No.
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�1 ' SIDENTIAL— OMMERCIAL
_jibe
IRED
Plumbing Permit
in Heating Permit
in te
v► yi Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOUTH
I hery certify information submitted is correct and there are no other structures located on this property except
shn
as . n --.) 4. 7 ';
Owner 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
our street address will be C � , ,!�
�L� � • /5 _ The zone s��/�
Sewage Permit Number Issued Building Permit -So/)I'. Receipt 4iri Issued
Remarks
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Form 523 Bldg. Code
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