1978, 10-04 Permit App: N0905 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE z) Ja
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 most 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 47235.
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 — OtAS Address one
Architect Address Phone
Engineer Address (..•---"_ -n Phone
Contractor QL Address U 1• r L ~' Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) ParcelNumber
5 .1- -A i Tr4GN- t,
`Sc( o'taa
DESCRIPTION OF WORK: New / \ Addition
Size of Lot 9 5 x l
6
Remodel Moving Bld . Zo �— Fire ZojtQ
Sewage System CConst. i`
b (Fr , Conc.. Br., etc.)
Stories _Dimensions O�In X ?le t' 3,3i� o2s $ X In
u( art, none Kind
O
otal Sq Ft V nation
ire Ia
Rooms l2 Baths a Basement Foundation Const g�n ct �] Chimney p ce�/ ���,,..���!!
UseHeatof Bldg. v
Typeevim. k ting/Z' S `_ / _G_m_in— t�Finish C r , e LY4 L.! kr No of Units Int Wall 1sh n.�Bed1 o ms 'f �el �
J ,`/lj �N1 (2.e_
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.
12-lw so/
NORTH
1e
-1
cc+ ke hC
ptr\ p(et . 43.11S
SOUTH
I hereby c Sfy inPormatip sub gyitte is co rect and
as shown. -"X//VrOiJ^
er or gent
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES
THIS IS NOT A PERMIT.
oN MYri' lb/`77,1"
w
N
y
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
there are no other structures located on this property except
N
Date
BEFORE CONSTRUCTION COMMENCES.
DO NOT WRITE BELOW THIS LINE�{ �-
AS
Your street address will be S .32_ M0'E(1'1 .5'T,FF7r t �vThe zone is AGRIc If LTURAC
Sewage Permit Number Issued Building.'% Receipt 836 1 Issued
Remarks
Form 523 Bldg. Code
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.S 3 23 Moe► S'ir e+
rim,.,et b of BThc' 26 of Coriiri Addition to Qr enacres as-1'er
.LU Vo1une "1.:;" of pt_t`s.rit,jia/re 30, situated in the
u; j •.t.c 'oy
Washington, uc.icr:ibed, as, follows : 1, _.
;,'•t11 .Eouthwe.,t corner of cid Lot.:3 on the Northside 0
raurtii h•.,•enue`•CeinC•'40 feel :tide, . thence Seut}i .8 ' deg. 40 'ming 55'see•!
asp alon :the Ilortli ra ht of way line of Fourti.'Avcnue .304/50 feet;
tt,henc_ NNor,C th . ;'do ..00 rain. 21 ;3ec. West 5•.p0 feet to the ,true gint
of 1��,,it.'rilnr;';tnericti'col�titnlir�l;
North 0 des.' DO.f;iin..21 uec. 4/eat'
.. U^ '', it„ '•tti®uce ltertl� '89 r.tegu. 140 riin, . 55 ''beca' (Jest 120: feet ' : thence `
ri
-lv*A;I' i1 Cl( - C0 ;):1?a %1 `. t'C.n! i�:u t 75.11 :!0(±t', t:1101160 uo to •L;! C�C:(u 50 rdiio
'� F. C �i,•s ( i i]c e. 1 11'.!i)C( SGLIth `- N, 89 .deg. /To:, .i3C e7 11 ,1
. •, '' k
1' :r . ..` .!:' (') i'I(:• .c•onte'rlin C}ir'''oUrth Avenue, ,1100. 1 feet to': the'.f;l.ii pep ist.
ax ae1;s, 1;
nt ppv,tion..aof, 0orb4.a Addihion to Greenacres per
-143.4t; therooi` rc�c;ox at�d,;tn Vo u►nc "4-.3", of plat&& at r e ,;1)0 situated in the
County nof app}t ,i'e .,tache Of :Washington,' dggscr7b
tl , \ f 1
ommencink Southwest , cbr, tierof aai.d Let:',6 on the 'Northsiirid ;n
Fou th 4venuq boiri feet wide; thence North .0' deg:; 00 mina,;,17 Msec.
West a, ct,ia ;:ince 5 00, feet to the true j5oint 'f beginningA ,thence 'South- i.
89' def; e:40 rilin,, 55, S`r G` ' i;a t t7arii11e1' to 3atd `F'o'tx th,'Avenue 11Lf 39 . f'eei;,
t}aurie�'a;dort}r''�� delta'' 09 tni.n ', 2a 'sec; East °2.,8.36i, foot', . 'thence,' North`;
00 21 secs ,West! » .89' fMet+ ;:hence IN Worth 55 `pec.
Weat'i'','#.4`•.� 'fect1"1thence South; 0 'deg. 00 mi'no �'�, sec.' fast 9•0C0'foet
the tto ; point
• •
APPLICATION FOR CERTIFICATE OF EXEMPTION
To Li
PLEASE PRINT OR TYPE t. S C O+or�
1. Applicant's Name: LE --(A,) Z P. R L ��r L 1 LA�h�'hone: Res: S 3$-1 q gb Bus: Saw\C.-
Address: (:t 0 E `j 4_ C. City: �pO Kik � State: U.J�s� ZIP:99((X,
2. Legal Description(9f property for which this "Certificate of Exemption" is being applied
for: Section '7 Township as Range Y1/4.3
1" (a
3. Parcel Number (From Tax Statement or Assessor's Office): # j JGl 5 J —Q /
A09FickForr;(
b. For which of the following reason(s) do you believe you qualify for a "Certificate of
Exemption"?:
c
4. Size of said property: Square Feet:
Intended use of said property:
Or Acres:
(For each box checked, please submit the listed documentation required to substantiate
your exemption. In addition, please submit an assessor's mal 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.
EiB. Minor boundary or lot line adjustments
DOCUMENTS OF PROOF: 1) Adjusted legal description; 2) Copy of sales/contract
agreement.
E] C. 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.
DOCUMENTS OF PROOF: 1) Copy of tax statement; 2) Copy of deed or dated copy of
sales/contract agreement
DD. 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.
E. 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.
DF. 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.
7• 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
.t might issue in reliance of this application.
NOTARY SEAL
Signed:
Notary:
Date: / / /6' /2z
Date: 7 //e /2_
APPLICATION NO. Ce----,e,3-41t
•
SPOKANE COUNTY SHORT PLAT SUBDIVISION ORDINANCE
NOTICE OF ACTION ON CERTIFICATE OF EXEMPTION APPLICATION t)
Whereas, the Board of County Commissioners did, after public hearing on March 9, 1978, adop
i
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
1 action on this "Certificate of Exemption" application, pursuant to the Spokane County Short\........ ....)
Plat Subdivision Ordinance.
(� AAP�PROVA3,
- Certificaof 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? -2 - 3./ t 3.36/
Approval of said "Certificate of Exemption"
and issuance of building permits, shall be
subject to the following conditions:
The applicant shall comply with all re-
quirements and regulations of the Spokane
County Zoning Ordinance.
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.
di-;-z-,-Zdi-L-62
�o C�
This "Certificate of Exemption" is and shall
run with the land and shall be applicable to
i the applicant, owner, their heirs, succes-
sors or assigns.
APPRO1, ED THIS /5 DAY OF , 1974 .
%S
SPOKANE COUNTY
PLANNING DEPART-
MENT STAMP
t Plat Administrator
IS CERTIFICATE MUST ACCOMPANY
YOUR BUILDING PERMIT APPLIfCA.' 01�
a l
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:
•
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