1978, 09-26 Permit App: N0857 Residence W/Garage Cour_• of Spokane. Washing `on
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99260
e)()APPLICATION FOR LAND USE OR STRUCTURE PERMIT /-4-'
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. Con-
struction must have inspections.
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 is required. See current
Spokane County Zoning Ordinance for all required set-backs.
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 building(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 rT�HIS LINE ii4iL,,,e_a,e4e4..... yr,�G,'
Name of Owner_. ,1_-/��i . a�<' I i Address(�_/1�T1. UC H- Phone �o 1���
Architect .. Address___ _ Phone
Engineer_ Address_ Phone `•
Contractor " / JI Address: ��/yC — 9.2l�Phone f—ff/7
Legal Description of Property Give complete description from deed, tax receipt, etc.) Parcel Number_.f, 5si " eq'/
./ ha' .Tr 4' • / f &. JV' O D no -:-A/ 7 ! . _ ,x136 d
-I _ 1 '4 I 3 .-r l "Fro_ _
DESCRIPTION 9IF WORK: New X _ Addition Remodel Moving BId . Zone I Fire Z e3
Size of Lot ( +`L_ __.._ Sewage System 1i 1 �` Const. `-" ✓y --
//ll i z• j • (Fr., Conc., Br., etc.)
Stories . Dimensions 41Xc2Z, I X X..- f} __ /�., /Total Sq. Ft.,2gg4 Valuation_.(e_4 '`-�L -
Rooms 7 Baths 3 Basement 44 Foundation Const. C'-a- - --a�-e i Chimneyd�i,,' '� Fireplace9
(Full, part, none) (Kind) (Number �y
Heat. System ,�� . = Typeoff•oofing : ✓"! E, . Finish T—!// Int. Wall Finish £. f.{ / .aIP
Use of Bldg. % .. AO- ,'„is /.' , .A A : i -I r No, of Units Bedrooms
ROADWAY R/W WIDTF 4 !
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.
T NORTH State License No.
r
I d. Ins. Acct. No.
7StA a 3 g 4.
A ` -/Q - RESIDENTIA '- COMMERCIAL
REQUIRED
Plumbing Permit
m Heating Permit
m
v+ H Sewage Permit
-I -4
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
97..?0 f 444cAr
SOUTH
I hereby certify informatio .gitteI. '. correct and there are no other structures located on this property except
as shown.-�iy-At /e/ 9/2.4/7k
7k
Owner or Age7” Date
A LAND USE OR STRUCTUR PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS OTA PERMIT. PERMITS ARE NON-REFUNDABLE AND NON-TRANSFERABLE ._
qiki ii if rc' DO NOT WRITE BELOW THIS LINE ('
i Your street address will be y4.De
i ,
/ C- ��� / the zone is
i Sewage Permit Number Issued __ Building rmit Receipt f` Issued
Remarks _ t. �r„��. '
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Form 523 Bldg. Code
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APPL .TICi3 FOP CERTIFICATE OF EXEMF )N
�`x�,y93 '
PLEASE PRINT 0, TYPE .1 •
1 .. Applicant's Name: R01 32 r Ll.J1 S-e VIA ci. •,, Phone: Res: q,q-ls i(,O Bus:„f, c 6
Address; C, 1 %U l 1.0 Prt1( : City: G,-�eb.gGy..1,S, State: U )�s k • : q _
. .
2. Legal Description of property for which this "Certificate of Exsuw,4i,ge J 4 biaim : �sd
for: Section / g Township 2.A , Range L/52'.L&,dVt• ' . . r , ..i ' t i• _ ,.
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�4—. •.l a. =..I ��.Il .� •� �. _ . ..4. .�� a 1 l
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I1 c . 1-14,"""-11 f 11.t-m- C1 \ ' wo--- 5- .Al 4A-A, P •,01.0 i( ✓ t.
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r . o, l -t it, �. Ki' "'v t ,t , . 0- .
• ► f /S, / I . 1/ .. � / •� ...r.: ►� ' •�•
3. Parcel Number (From Tax Statement or Assessor's Office): !*�;, �/ ` :'— ' •• _ .x.„
4. Size of maid property: Square Feet: 3 ./ K ' St ; ki o';
� ►. R.'�:• of, .
5. For which of the following reason(s) do you believe you qv ,” ,
Exemption"?: • , , A ��
(For each box checked, please submit the listed documei tatio `r,% A � s ► .
your exemption. , In addition, please submit en asye
run of your property, both obtainable from the Tax As s {{{/�/�/� : ,�' . � go., , ,'
phication)• ,; L. • 4 t
,
' i F t + 1 •
0 A. Division of land ten (10) acres or larger •; ,; ri 1,' �' `•
DOCUMENTS OF PROOF: 1 ) Assessor'+a map and eiwzsreb.tp ;sd,s0e ', '''rf 1p,S0 4.,"
above. ',', '`..+' ; 4 ,, . .
0 B• . Minor boundary or lot line adjustments • . "' „i ` `'t , ,". i'i'1�� •+`i)71,,'•
DOCUMENTS OF PROF': 1) Adjusted legal •deseriPtoq,;`,,*}•q j'1,, `1' '•, 4"a4t.
agreement. .-4'y, k ;,;(,•,,",. 1 ( t,.:..
C• . The reconveyance of old lots, tracts, or Parc ►7-# ii° .! ilk
and distinct when purchased, although the p !'theme .. ,' c 'h * ; ,
contiguous. :1-',.r 7 A', " . .4tt;t , Vr
DOCtit+ TS OF PROOF: 1) Copy of tax statemer ; a) ,C . „Ot
sales/contract agreement ' '' a ii.VJ'F,'r'T '+ .! ii,te. ,
f
O D. Division of land created prior to March 13, 1978, ;' 11104. i t Ox •
larger. ,
DOCUMENTS OF PROOF: 1 ) Copy of deed or dated copy of'�' .W '. At.
,, x y�, � , 1978.
O E, The purchase of one separate and distinct parcel o$,,�, ', , , .`? ‘
Co of deed or e " ! ►1 ';'rozant..•'
DOCUMENTS CO' PROOF: 1 ) Copy d,�t ��,ap,�T�
g F. A. division of land to a spouse, son or de t •,1
' DOCUMENTS OF PROOF: 1) Copy of deed/Quit GClaim Deed`a Masi'ep •4t`m .ae/cony
tract *Fremont. 2) Notarized affidavit attelat tp sa .d 3704049NONPfc
6. Additional comments which may substantiate your qualification Sor an i.QaP
I, the undersigned, swear under the penalty of perjury,, that the above raapasaaparapade
truthfully and to the beet of my knowledge. I also agree to furAish ow r dooumep.-
tation that may be required by the Short Plat Administrator_,tea,I hereby agree to waive
the five (5) day approval period as specified in the Snort Plat Ordinenos ,f' further or-
oration is required. I also understnad that, should there be any willful misrepresentation
or willful lack of full disclosure on my part, Spokane County may withdraw any approval that
it might issue in reliance of this application.
signed: ,// . ....,.# iL 4, , ,m, Date; .. f 2<
NOTARY SEAL Notary: �V,Ie�7 I -4. _.,t. Date: 7 I1
. •
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APPLICATION NO.C'E-0a '+� , ;,; 4'::
SPOKANE COUNTY SHORT PLAT SUBDIVISION ORDINANCE '
NOTICE OF ACTION ON CERTIFICATE OF F 'Ict APPLICATION Whereas, the Board of County Commissioners did, after public hearing on March 9, 1978, adopt
the Spokane County Short Plat Subdivision Ordinanoe, and
Whereas, the Board of County Commissioners in adopting this Ordina c cii did provide i 4 rtiask: l,,
activities to be exempt from short platting activities, and , . .
I Whereas, the Board of County Commissioners did further provide 1p:' cIIrtair*.Agtilri,t:tIas ,/
i
to receive a "Certificate of Exemption" from the Short Plat Adeltnatratcx ril)r-;tc.•,,tb. ?x'e-
lease of a building permit, and ' Ake •
•
Whereas, the Short Plat Administrator has received a request fora "Certificate of 8 mpttoris , ;
for certain property located in the unincorporated to?i tor� `oX 44i Coin o 4 "
Whereas, the Short Plat Administrator has reviewed the evidenof'.'p ` $onted 'by'' ;. cb
and all other information available, the Short Plat Adtt:4ni.strater lesxcaby :444411:1441 4014..914,
action on this "Certificate of Exemption" application, t t'O the � C ort • ;
Plat Subdivision Ordinance. .,N ' ,.. .;• `'',$ 1 ZI'''' V%i!i.t4„ r':' cg f'
. '-.. i 1' ! Y. 4. 1‘- ..i'. N.� ■ TI ♦“, / •
'Kt..,
4i
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- Certifica emption .- r..; Pirt t F , MuR, .a4 3w
T. 1 P
The Short Plat Administrator finds that a The Shot t ,4at MdOin ',e*Or' f"C the*. a °
"Certificate of Exemption" should be and "Certifioate of ToOKOMPt4,40 lhould, at:and
hereby is issued for said property, as de- hereby i s•a 4 ;Ism. 0E.d op�► as
scribed on the reverse side, pursuant to deacrihed'on the 'q'V4T,de sl.4e,' 'ptrent to 1
Spokane County Short Plat Subdivision Or- ° , Spokane County , ►t,, .8Xb ;vd.aion Or-
dinance Section �� 3 • dins:ce Seotian + '. {, x ;foc'•the follow.
Approval of said 'CB ertificate of Exemption" 44$ reagoo,a,. ' t . .i.o •
and issuance of building permits, shall be ; t ' , , '
subject to the following conditions: 1 . ,'
1.
, p; S . 3 3 �: r, , •
0 The applicant shall comply with all re- . • , , .
quirements and regulations of the Spokane . •.�� :►' •
County Zoning Ordinance. ! fir, 4,{1, ,-'i ', 1
0 .- 41....0.41r,111,4dif;41.4/4_,..L46,12:16e - f •
The applicant shall comply with all re- 2• s -r.
quirements of the Spokane County Health ,
District regarding the placement of on- t
site water and/or sewage systems. ` '' t
J �. '11 r 1
■
• According to the Spokingv.;0144t7 Short Plat
4. Q. r Subdivision Ordinance, the division, of
' land that you propose to develop is defined
as a Short Plat and you will be requ4,red to
comply with the requirements of maid *rdin-
ance prior to issuance of buildifl` iaraita.
This "Certificate of Exemption" is and shall I.
rum with the land and shall be applicable to
the applicant, owner, their heirs, succes- .
sore or assigns.
41 APPROVED THIS DAY OF :We , 19 D HIED TSIS _! ! !'. ,' 7. ,�eNTPrr+.
/ I ,C. '
a, „,,
,A,4.164.. ■-
l'A/ S. 't Plat ..inistrator Short t Administrator
SPOKANE COUNTY SPOKANE COUNTY ,�,=µ' '�" .
PLANNINd T PLANNING DEPART- ,.;.. .,s,....-:- '
MEt� STAgANt-COUNTY PLANNING DEPARTMENT
KENT STAMP ti••
Nei:1H 311 JEFFERSON STREET : 4.,- +'
{ SPOKANE, WASHINGTON 99201 —
s
THIS CERTIFICATE MUST ACCOMPANY
YOUR BUILDING PERMIT APPLICATION . '