1978, 05-31 Permit App M6603 Addition11111
County 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 mast 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 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
which are enforceable through civil action. County Officials can not bring action to enforce covenants or
y I ' / by `/ I a c�+� 7 �.Z ' -,�. / v2'
Name of Owners-�f v" Address Phone /
Architect Address Phone
Engineer Address Phone
Address `'�f�"` Phone --_
Contractor
APPLICANT FILL IN BELOW THIS LINE
Legal Descrip 'on of Property (Give comlilete description from deed, tax receipt, etc.) Parcel Number
Lc; >/firf 'ate
'K / i= y&'
with the land
dedications.
DESCRIPTION OF WORK: New Addition Remodel
Size of Lot
Stories (,
Rooms /
Heat. System
se of Bldg.
r0 X `
Dimensions
Baths / Basement /VOA" '� Foundation Const
(Full, part. none)
lit /C/2Ty of Roofing �G' Ext. Finishv
Moving Bldg. Zone
Sewage System �X/ %rr.` p% onst.
V �F►., CBr-etc.) . @—
Y/� Total Sq. Ft x S '�yValluation / 000
Chimney &Le_'� Fireplace s /
/ (Kind) (Number
/� Int. Wall Finish Oj w
No. of Units _Bedrooms /
e
/
Fire
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.
m
tn
-4
NORTH
ba
SOUTH
I her by certify infn subaiitt
as show .
yn
RESIDENTIAL COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
orrect and there are no other structures located on this
er or Agent Date
property except
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
DO NOT WRITE BELOW THIS LINE
Your street address will be
Sewage Perm
Remarks
F-7 /i'G 07, ze4u,
umber Issued
The zone is
n Building Per Receipt
Form 523 Bldg. Code