1978, 02-23 Permit App: M5020 ResidenceCounty 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 say
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.
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 47235.
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. Rork 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 OP BUILDINGS. A permit is required to move an existing building. When a building is moved on a Comnty 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 dedication.
/ APPLICANT FILL IN BELOW�THIS LINE I
Name of Owner �iLa-,� N � A+rzU> Address yv r T 426,, / ez v3--r8r
///��� Phone 77J
Architect `�� Address 4./earjao� Phone
EngineerAddress .3835 Phone
Contractor .lL.�% +-.rr.e Address
Phone
1 Legal Descripti of roperty (Give c pia description from deed, tax roc ipt etc.) Parcel Number � 4 42-5,-,44,_7- 9067
is /f-� �-.7 £Z
DESCRIPTION OF WORK: New c— Addition Remodel Moving Bldg. Zon Fire Zone
Size
rnnr..,,of Lot £ a 3-n -, h-)..• Sewage System s— pont.�r flt4-
S(ories I Dimensions -4—'5' Y.3L I Fal, Conc., Br.. etc.) `c
Total Sq Ft % Valuation Gri nos
Roans �f Baths a- Basement Fv 11 Foundation Conal r b h ,- v6.Chimney ( ) Fireplace/
Full. part, nor— ry
Heat. System e 7Rl,,#/,'� w
Typo of Roofing Ext Finish ef-e`"-et' Int Wall Finish
Use of Bldg. m 92.. No of Units ..Bedrooms f'
/a) 50' 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 sirs
tem a,.:.: ter supply lines.
NORTH
vs
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tn
State Li cyys No.
Ind. Ins. Acct. No.
` Rall( NTI -COMMERCIAL
REQUIRED
Plumbing Permit j (roe
Heating Permit
Sewage Permit ("Cr -
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Pans Mailed
SOUTH
I hereby cert i formation submitted is correct and there are no other structures located on this property except
as shown.
c' 7.3-
Owner or Agent Date
A LAND US 'e R STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Tour street addres w111 be JO 9/4 % O &-czAr.-1 The zone X�1l5�/
Sewage Permit Number Issued Building Permit II- s 01-eyv
I Receipt 7 Issued
Remarks
form 523 Bldg. Code
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