1978, 06-09 Permit App: M6801 MH1;i°
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
D
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 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.
R ICTIVE ANTSu'.1.4 should check provisions of covenants or dedications and easements running with the 'an:
1 :�. �;:bi • ction. County Officials can not bring action to enforce covenants or dedications.
11 APPLICANT FILL IN BELOW THIS LINE
�i zU
Name of Owner ...I ,. 4,,, :'_ .d., II Address a . ' T ' . _ . Phone's 34 -4.7 t /
Architect Address Phone
Engineer iiAddress 99-2,-,Z.Phone
Contractor .r/T ,e,/ 4"1 etQ .4.I -f 4 , , t1 Lf-' Phone ,"S - � - 0 6S 7
/ - - ` - .T/i /.54
Address P(, /J ? Q > ` 774 . R
Legal Vescripti of Property Give complete description from deed, tax recei t, etc.) Parcel Number 2
PoR r i7 AJ cif4i :LN — �� ALT /4'T.ER. ,E, LN o -t C.4R
3.4 4 vE i • E. A ,_ , cf Alli D!J/ Ti`f N. PAR.
.
,4j,4 /*AAl. CBO ' Td rRO.E Pe.'
its'
N �F W'ORK: ew )_ Addition
Size of Lot /C1C,X <:LG'CJ/
Stories .L_Dimensions J X
RoomsBaths. Basement %r`i
Fu kI, part, none)
Heat. System /1 .Type of Roofing
Use of Bldg...'/L - .i. f _C641
/4.4 Al RD. V- it/..G /V
Remode l
L) / 7 -W -
Moving Bld .Zone ;' Fire one ._
Sewage Systemi>I LL�.tt� r %LtB
Total Sq. Ft
Foundation Const AA/Cf/0k /A/ G'QN(,'Ei•Chi
Ext. Finish
n
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.
const.
(Fr., Conc., Br., etc.)
v Valuation Fie' d 19
f"
A 2
mney Kind) Fir�plac (Number
/'
Int. Wall Finish i.(/�1,(-P_
No. of Units _..Bedrooms
s
te
I her" shown.
Owner or Agent
SOUTH
rtify information submitted is correct
and there
State License No.
Ind. Ins. Acct. No.
RESIDENTIAL, - COMMERCIAL
REQUIRED
Plumbing Permit
▪ Heating Permit
• Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
4// 77 t d e. di= •
are no other structures located on this property except
7,., —9-7�
Date
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 j, j 2.Lf e.a.„ ,c 4/1,,r,r.e
Sewage Perini N ber Issued Building Permit
Form 523 Bldg. Code
PLEASE PRINT OR TYPE
APPLICATION FOR CERTIFICATE OF EXEMPTION
1. Applicant's Name: Pacific Gas Transmission Phone: Res: Bus: 534-0657
company
Address: P.O. Box 4389, Station B City: Spokane State:
WA ZIP: 99202
Legal Description of property for which this "Certificate of Exemption" is being applied
for: Section 23 4 Township 25 N Range 43E
Corrcing at the intersection of the East line of Carnahan Road and. the North line of
Third Avenue Extension as conveyed to the State of Washingtor1 thence East along the
North line of said Third Avenue, 200 feet; thence North and parellel with Carnahan
Road, 260 feet and the True Point of Beginning and being a point on the agreed boundary
line set forth in the Agreement dated Decer:ber 7, 1977 between Arerican Sign and
Indicator Corporation, a corporation, Professional Maintenance Company, a coporation,
and ioundup Co., a corporation, recorded January 6, 1978 under Auditor's tor's F'i le No.
7801060154, thence North along the aforesaid agreed boundary line, and parallel with
the East line of Carnahan Road, a distance of 100 feet; thence West parallel with the
-NOrth line of Third Avenue 200 feet to a point on the East line of Carnahan load;
thence South along the East line of Carnahan load, 100 feet; thence Fast 200 feet
to the point of beginning.
uor eacn box cneciea, please submit the li'stea' aoc"umenza£ro'n-3• e'c1arreu thT a-eaaT Lt.10.V:.
our exemption. In addition, please submit an assessor's oz. and an ownership micro
run of your property, both obtainable from the Tax Assessor's Office, with your ap-
plication):
0 A. Division of land ten (10) acres or larger
DOCUMENTS OF PROOF: 1) Assessor's map and ownership micro run as requested
above.
B. Minor boundary or lot line adjustments
DOCUMENTS OF PROOF: 1) Adjusted legal description; 2) Copy of sales/contract
agreement.
ElC. The reconveyance of old lots, tracts, or parcels of land which were separate
and distinct when purchased, although the purchase thereof makes the divisions
contiguous.
-DOCUMEMTS OF PROOF: 1) Copy of tax statement; 2) Copy of deed or dated copy of
sales/contract agreement
0 D. Division of land created prior to March 13, 1978, which is five (5) acres or
larger.
DOCUMENTS OF PROOF: 1) Copy of deed or dated copy of sales/contract agreement.
ElE. The purchase of one separate and distinct parcel of land prior to March 13, 1978.
DOCUMENTS OF PROOF: 1) Copy of deed or dated copy of sales/contract agreement.
0 F. A division of land to a spouse, son or daughter
DOCUMENTS OF PROOF: 1) Copy of deed/Quit Claim Deed or dated copy of sales/con-
tract agreement. 2) Notarized affidavit attesting to said relationship.
6. Additional comments which may substantiate your qualification for an exemption:
I, the undersigned, swear under the penalty of perjury, that the above responses are made
truthfully and to the best of my knowledge. I also agree to furnish any further documen-
tation that may be required by the Short Plat Administrator—and I hereby agree to waive
the five (5) day approval period as specified in the Short Plat Ordinance if further infor-
mation 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.
NOTARY SEAL
Signed`� /
Notary • /� ,. -
Date: 6 / 2 /78
ent-Ope aae9ns
PUKfU E C;U0fi € Y
DEPAfTMEft-
APPLICATION NO. q -
1 Whereas,
SPOKANE COUNTY SHORT PLAT SUBDIVISION ORDINANCE
NOTICE OF ACTION ON CERTIFICATE OF EXEMPTION APPLICATION
the Board of County Commissioners did, after public hearing on March 9, 1978, adopt
the Spokane County Short Plat Subdivision Ordinance, and
Whereas, the Board of County Commissioners in adopting this Ordinance did provide for certain
activities to be exempt from short platting activities, and
Whereas, the Board of County Commissioners did further provide for these certain activities
to receive a "Certificate of Exemption" from the Short Plat Administrator prior to the re-
lease of a building permit, and
Whereas, the Short Plat Administrator has received a request for a "Certificate of Exemption"
for certain property located in the unincorporated territory of the County of Spokane, and
Whereas, the Short Plat Administrator has reviewed the evidence presented by the applicant
and all other information available, the Short Plat Administrator hereby takes the following
action on this "Certificate of Exemption" application, pursuant to the Spokane County Short
Plat Subdivision Ordinance.
•
APPROVAL
- Certi Exemption -
The Short Plat Administrator finds that a
"Certificate of Exemption" should be and
hereby is issued for said property, as de-
scribed on the reverse side, pursuant to
Spokane County Short Plat Subdivision Or-
dinance Section ', Z l3(/).
Approval of said "Certificate of Exemption"
and issuance of building permits, shall be
subject to the following conditions:
1. The applicant shall comply with all re-
quirements and regulations of the Spokane
County Zoning Ordinance.
4.
The applicant shall comply with all re-
quirements of the Spokane County Health
District regarding the placement of on-
site water and/or sewage systems.
This "Certificate of Exemption" is and shall
run with the land and shall be applicable to
the applicant, owner, their heirs, succes-
sors or assigns.
APPROVED THIS DAY 0
197K .
--6::-1-Short Plat Administrator
SPOKANE COUNTY
PLANNING DEPART -
MINT ST WANE COUNTY PLANNING DEPARTMENT
NORTH 811 JEFFERSON STREET
SPOKANE, WASHINGTON. 992.01
THIS CERTIFICATE MUST ACCOMPANY
YOUR BUILDING PERMIT APPLICATION
DENIAL
- Certificate of Exemption. -
The Short Plat Administrator finds that a
"Certificate of Exemption" should not and
hereby is not issued for said property as
described on the reverse side, pursuant to
Spokane County Short Plat Subdivision Or-
dinance Section , for the follow-
ing reasons:
1.
2.
3.
According to the Spokane County Short Plat
Subdivision, Ordinance, the division of
land that you propose to develop is defined
as a Short Plat and you will be required to
comply with the requirements of said Ordin-
ance prior to issuance of building permits.
DENIED THIS DAY OF , 19
Short Plat Administrator
SPOKANE COUNTY
PLANNING DEPART-
MENT STAMP