1978, 03-17 Permit App M5400 Residence, GarageCounty 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 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 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-arerequired.
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 99,2D(o
Address % �1� nCl , .� /'/.b L f Phone <'C t-34
Name of Owner
Architect t Address Phone
Engineer Address Phone
Address Phone
Contractor a!) (7 4-4te ,L
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number Z S 33'6G-'1 7
LD7- 2 I3 1(" 7 "lJAibl 17}/J-(t"-d ki,
1
ROAO!�><I sp_I IDTIL ro d
D S N F WORK: New ): Addition Remodel Moving BI Z _/._ Fire
/<j X j.i— AP'/P
^- j
Dimensions
Baths 2 Basement
(Full, part, no
_Type of
none
Size of Lot
Stories /
Rooms 7
Heat. Syste
Use of Bldg.
on
3
Sewage System onst.s 44t&
�Fr Con.. Br etc
� 1 X� f �', /1f -f Q-Z X Qc5 l 6�: /1/ Total Sq
' undation Const
rll. Ext finish]=//
Fling
) 00
. Ft �✓�� Valuation dr%
Chimney y"'-"4ri e ce
(Kind) (N u ber
Int. Wall Finish
No. of Units Bedrooms a
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 sys-
tem and water supply lines.
I hereby cert fy informatio
as show
Owner or Agent
NORTH
SOUTH
State License No.
GK oAJ FILL
Ind. Ins. Acct. No.
(RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
is correct and there are no other structures located on this property except
--1 7— 7F"
Date
A LAND USE OR STRUCTURE PERMIT M ST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
(-ar
-77 p )
Tour street address will be / T i t ,6).4:
•
Sewage Permit Number Issued Building Permi${-//Q (/
DO NOT WRITE BELOW THIS LINE
The zone isa4-4-(Viii-i/tea
Receipt 0 G 71‘ Issued
Remarks
Form 523 Bldg. Code