1976, 04-12 Permit App: L5348 ResidenceCRnty of Spokane, WaslNgton
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT sa
GENERAL REQUIREMENTS PERMIT FEE. -__c'?._/..
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. 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 throug civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BE W THIS NE Uc,1
Name of Owner Address one 4;iQ
i
Architect Address Phone
Engineer Address Phone
Contractor Address Phgge
Legal Inscription of Pro -Art
y (Gixe complete e-,pSr tion from deetl�eceipt, etc.)
DESCRIPTION OF WORK: New Addition Remodel Moving g. Zone Fire 3Pne �3
Size of Lot , O r /'S -o r ! Sewage SZ4
CFfnst Br., etc.)
Stori Dimensions e U otal Sq. Ft ((Valuation
i
Rooms � Baths Baseme Foundation Co st. Chimney Fire lace
Full, part, no -(Kind) (Number
Heat. System arpe Roof in ii0h / / Int. Wall Finish
Use of Bldg. . of, Units 4 Bedr s
PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road ations; (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 RESIDENTIAL — COMMERCIAL
as
M
a
State License No.
Ina. Ins. ct. No.
RE UIRED
Plumbing rmit
Heating Permit
Sewage Permit
Plans Received
Plans Checked,
Plans Returned
Plans Picked Up
Plans Mailed
I hereby�ertify Ah orma�,ipn submitted is correct and there are no other structures located on this property except
or
A LAND USE OR STRUT
THIS IS NOT A PERMIT.
Your street address will be
Sewage Permit Number
Remarks
Form 523 Bldg. Code
PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
Issued
DO NOT WRITE BELOW THIS LINE
Building
The zone
Receipt_