1978, 02-07 Permit App: M4987 ResidenceIs
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
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APPLICATION FOR LAND USE OR STRUCTURE PERMIT��
GENERAL REQUIREMENTS PERMIT FEE.
PERIMIT 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. 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 Yl Address Phone = �
Architect Address Phone
Engineer Address Phone
Contractor 5 C� `�� ( " ` Address Phone
Legal Dy c:ription o Property (Give complete des;oription from deed, tax receipt, etc.) Parcel Number �I �
DESCRIPTION OF WORK: New _X Addition Remodel Moving B19. Zone L— Fire Zone
Size of Lot j(_" X, Sewage System JO'z<_ �}+�onst. 'A2
-
�i 1Fr., Conc., Br., etc.)
Stories ! Dimensions 7S 7 Total Sq. Ft. --<E Valuations/fir,
Rooms 16L Baths -Basement �/ Foundation Const. l Zl' A Y, - Chimne
Fu 1, part, none) Y K— Fireplace
'/ (Kind) J (Num er
Heat. SysteType of Roofin �G`�YI2 Ext Finish % /-%� Int. Wall Finishy/cc)
Use of Bldg. :!::�, p,jL— 12c taC.Y/2e /ions;
"f Units Bedrooms
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of; (6) location of sewage sys-
tem and water supply lines.
M
u+
NORTH
State License No.
Ind. Ins. Acct. No.
RESIDENT! - COMMERCIAL
REQUIRED
Plumbing Permit
e+ Heating Permit
HSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
IP
SOUTH O� OZ + I
I hereby Ser ify Pifoirmation submitted is correct and there are no other structures located on this property except
as shown.
mer or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT APERkfI
DO NOT WRITE BELOW THIS LINE
.street-address
Your street address will be II The zone is
Sewage Permit Numb ss ed Buil ing Permit
Receipt Issued
- Remarks rk,
11
Form 523 Bldg. Code
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