1977, 06-02 Permit App: M1684 ResidenceCounty of Spokane, Washington
W)LD)NO 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.
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 - > Address / Phone
Architect Address Phone
Engineer Address Phone
Contractor Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number
-7,
DESCRIPTION OF WORK: New Addition Remodel Moving Bldg. Zone % Fire Zgne
r ^o
Size of Lot S 7C Sewage System �onstCo , gr., etc.)
Stories Z Dimensions / X � Total Sq. Ft. `� Vatuatior
Rooms L._,' Bath _Basement%lam �d Foundation Const. wC. Chimnel � Fireplace '`i•tc.e(J
r Fu I part, none) �-- (Kind) Number
Heat. System Ty of oofi g Ext. Finish / %� Int. Wall Finish i
-'s
Use of Bldg. — tz No. of Units Bedrooms `h
' PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations;
proposed buildings; (4) distance to property lines a,d streets; (5) dimensions of buildings;
tem and water supply lines.
NORTH
P", ezt,�
SOUTH
I hereby certify in�G
as shown. ///
(3) location of existing and
(6) location of sewage sys-
State License No.
Ind. Ins. Acct. No.
/RESIDENTIAL COMMERCIAL
REQUIRED
Plumbing Permit
rw Heating Permit
NSewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
and there are no other structures located on this property except
Z.l
J Owneeor Agentto 1
A LAND USE OR STRUCTURE PERMI MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Tour street address will be ��" °�
- �*4 The zone is..�..1A�y�t�t:.
Sewage Permit Number Issued Building Permit Receipt Issued
Remarks
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