1978, 01-07 Permit App M4546 Residence, Garage, Deck111
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE Ci11
-19
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 witb 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
Name of Owner (f/ . S /'� S s� c_ /.[/t_ Address <-c' " ,2 C /%(/.CS Phonecea
Architect Address a Phone
Engineer Address Phone
Contractor c/I pn C Address Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number
f LUc,< / ltlien c/ / .ci7
Addition Remodel Moving Bldg. Zone / Fire Zone 3
Size of Lot .2 2 z O - ` i 4-X fL G) Sewage System --� •L.0/7 L onst. �2f� '_
2 Z r� z L./�Fr., Conc..
Br., etc.) cs�
Stories _Dimensions He u S S`� '� 2 P--) 6 te."16 CaX-V-tr) 21 cc": Total Sq. Ft 2 6Valuation 8_• • y `
Rooms Sr Baths �- Basement it= ci r L Foundation Const c-' AV (— Chimneyrhlk_a`' Fireplace Zl
(Full, part, none) (Kind (Number
Heat. System / 4 Li- [ Type of Roofing >SA' .Sr/.+l•e/L Ext. Finish vf/cvco '' Int. Wall Finish Pr-7 i- 'A'
Use of Bldg Si.- , i PA/P1i �hs iOL.- L Gv!%:1 ( ) ri 7-. No. of Units Bedrooms -- ?
1'3 a c c9r✓< L "a csaK.
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.
DESCRIPTION OF WORK: New X'
NORTH
SOUTH
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL - COMMERCIAL
REQUIRED
Plumbing Permit -.-v"- /A'i/ /17:
Heating Permit S -
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I hereby cert y information submitted correct and there are no other structures located on t is property except
as shown. ����-,-��
D/7/7
Owner
or Agent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
(r w DO NOT ,,WRI-�TE/� BELOW/,THIS LINE
Your street address will be / 61 / 1 r '�%Z /I IC��tsL-e The zone is -
Sewage Permit Number Issued Building Permit % 25/7/ Receipt f % Issued
Remarks
Form 523 Bldg. Code
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