1978, 04-12 Permit App: N5794 Residence County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201 7
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 3/
GENERAL REQUIREMENTS PERMIT FEE L.()
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any i
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. Cc
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. 45-13.1and 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 Va "1
l�� t V\ C "ik T V- Address I Phone 1` I ' 33S-3
Architect _- ••' Address Phone
Engineer Address Phone
Contractor Address [-Pho e ,
Legal Description of Property (Give om lete descri tin fro deed.itax receipt, etc.) Parcel Number .21..9 1 - � 7
Lel 7 3 1
its I\ Nisi ts `
ROADWAY R/WHWID k( r� / •.3
DESCRIPTION O O K: New` Addition Remodel Moving B g. Zone Fire One
Si of Lot L 1�4+ Sewage System y Const. i
p` �,,�. y,� [� r(�'� R Fr., Conc r., etc.)
'�i `Stories�rC7�Dimensions � �"-'1 I I �V ` " r Total Sq. Ft. Valuation5(�6�j
Rooms 7 Baths Basement F Foundation Const. 'ANC I*07e Chimney Fireplace i
(�� Fu I, part, none (1___
ind) (Number)
Heat. System V rex?of Roofin Ext. Finish \th `,'-" ' Int. Wall Finish 't� ivyIUse of Bldg. 41 ' 4 No. of Units IBedrooms k
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 and water supply lines.
NORTH State License No.
Ind. Ins. Acct. No.
�� i RESIDENTIAL-COMMERCIAL
i''°i
REQUIRED
l :
i / Plumbing Permit
(, m Heating Permit
in us Sewage Permit
(• .4
Plans Received
Plans Checked f
Plans Returned
Plans Picked Up ".____
Plans Mailed
SOUTH
I here certify� i formation bmitted Yp�is correct and there are no other structures located on thisfproperty except
as shown. �'* ) . U:17t1i(y \ � t I r
C l ` t
Owne or Agent \ pate
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
(944 74/64WV, DO NOT WRITE BELOW THIS LINE
// i z
Your street address will be I�i I �- J 1 The zone is _ ` ' , ',�
Sewage Permit Number Issued Building Permit I Receipt�^ 2,?- Issued
Remarks
`— j `_(
Form 523 Bldg. Code
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