1978, 03-02 Permit App: M5161 Residencepir
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County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT S
GENERAL REQUIREMENTS PERMIT FEE.__,6__L__-- :.
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.
NATER. Nater 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. Paints 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 �y� �N S7`s? �rci`iw,.l Address t3l))e J J4 66 :3SOc� Phone t_=� Z 2.D'.2 Z
Architect Address Phone
Engineer Address Phone
Contractor twJ bs1G C-VN51Z e_7-icAddress Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number
r L.11F i c. rr
DESC IPTION OF WORK: New Addition Remodel Moving Bldg. Zone Fire Zone
Size of Lot _ Sewage System-' Const.
1Fr., Conc., Br., etc.)
Stories�Dimensions Total Sq. Ft. �'� —Valuation Jioo0
Rooms � Baths Basement Foundation Const. C-Cr1��, Chimney !�'►"i3 G Fireplace �
Fu I, part, none] (Kind) (NuM
Heat. System Type of Roofing Ext. Finish "T1i1 Int. Wall Finish
Use of Bldg. A,.o ' A�. N--)e„Uniitts�Bedroojm�s
PLOT PLAN 4(PU '�”%n¢ r/
Draw sketch with dimensions showing: (1) property lines; (2) street or road locat ons; (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.
I hereby certify
as shown.
NORTH
�7W
SOUTH
State License No.
to b O
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permits
M Heating Permit A 4a&, -V A>7 f-
NSewage Permit'
Plans Received _
Plans Checked _
Plans Returned,
Plans Picked Up
Plans Mailed
ion submitted is correct and there are no other structures located on this
rty except
0� Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT M ST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
DO NOT WRITE BELOW THIS LINE
Issued _ Building Permit
The zon
Receipt
A4
Form 523 Bldg. Code ��
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SOUTH E` LR6r'L'Lt\i ����