1978, 03-21 Permit App: M5320 Pool•
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
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 mast 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 942 6
Name of Owner �v Address L Z/ O/ Q J
Architect 1' Address Phone
Engineer Address Phone
Contractor ����� -� Address Phone
Legal Descrip ion of Property (Civ omplete description from
deed, t re ip etc.) Pgcel Number t 5/Yv2 — , 0 7
Phone!^2� Y72
0t 7 .
ROADWAY R/W WIDTH
DESCRIPTION OF WORK: New Adriition Remodel Moving Bldg. Zone Fire Zone
Size of Lot
' C ' X / Sewage System (•=15-- /Y/ SI /'4jConst. / `OJT /4-r��
-� t C7-/'47
(Fr., Conc., Br., etc.) o v
Stories Dimension % 0 X " Jf Total Sq. Ft 700 aluation 0
Rooms Bathsl/� Basement �����r
�Foundation Const ( ber
(Full, part, none
Heat. System , ' /✓�/ Type of Roofing -Ext. Finish
Use of Bldg.
Chimney
PLOT P AN
( in
)
Int. Wall Finish
No. of Units _Bedrooms
Fireplace
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-
tteand water supply line
4/ 4/
NORTH
,s7(r7
,fie J f eI'4 L �
d° L
o
SOUTH
ESIDENTIA COMMERCIAL
REQUIRED
Plumbing Permit
rn Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
3/a//Rieur
I her b certify inforr tion subb1 ed is correct and there are no er structures located this property except
af'l �' r` rte,, ,2 / — 7 7
Owner or Agent ''-' Lam✓ Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
as shown.
DO NOT WRITE BELOW THIS LINE
Your street address w111 be
Sewage Permit Number Issued Building Permit
Remarks
J/ o /g 7�
e zone is
Receipt 07 Y Issued
form 523 8Idy. Code