1978, 05-22 Permit App: M6454 Residence400
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT fir 7
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 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 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.
5D
MOVING OF BUILDINGS. A permit is required to move an existing building. When a building Is moved
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 LINEpp
on a County or State
•
Name of Owner
Architect
Engineer szt
Contractor
LJ .4 .44
Legal Description of Property
ate, -Let, 99 14
Address ✓ 1 '° - i 1 � s Phone 922 S8,4 7
Address Phone
Address Phone
Address Phone
(Give complete description from deed, tax receipt. etc.)
Parcel Number 0 7%%TS — 3/O
Mt/ i7tJ1r>7.F..3-412.1 TRACT/6
. Lel r-PAe,Q, .Q.t-/-072lca-w /lie . PLAT 11
HUADWAY R/W WIDTH — Go
DESCRIPTION OF WORK: New >e Addition
Size of Lot -a. 3 aditi-ext,
Remodel Bld Zone -L one
Fire
Sewage System 1 Const.
Moving
xa X /y f Fr., Conc.. Br.. etc.) O0
:,1 QX n -t ,'L(n K.2�s'F 7K -t? Total Sq. Ft.---151-4::±1Valuation S7 YO/
)Nu —
)
_�1 mQ .Foundation Const -ti 'X�'^tf .1:- Chimne place/ nieA-n.
r I (Kind m er fi
0o g ./ i._.' �p.Ext F ishj // Int Wall Finish ill Wil vQ
a/}e1-(I P. Art .LL.I LOt No of UnitsBedrooms All
StoriegCDimensions -24A/c2‘2�•Z,'
Rooms 7 Baths .2 Basemen
(Full. part, none
Heat. System Type of R
Use of Bldg.
i
Draw sketch with dimensions showing: (1)
proposed buildings; (4) distance to property
tem and water supply lines.
NORTH
PLOT PLAN
property lines; (2) street or road locations; (3) location of existing and
lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
I hereby erttfy in
as shown..
SOUTH
r tio�bml is correct and there
m
y
State License No.
Ind. Ins. Acct. No.
RESIDENTIA
- COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received -
Plans Checked
Plans Returned
Plans Picked Up
Plana Mailed
are no other structures located on this property except
,5702e2/72
ner or Agent Date
A LAND US OR STRUCTURE PERMIT MUST BE ON THE PREMISES. BEFORE CONSTRUCTION COMMENCES.
THIS IS NO A PERMIT
Tour street address w111 be CI /7'-M& � ,A.t./A �.IYdLCLi-t /eh •'�The zone is
Sewage Permit Number Issued Buildi g Permit'j,%, 54a-3/Receipt 3/Receipt ,24 1 Issued
Remarks X77
•
DO NOT WRITE BELOW THIS LINE
/jmd 5 .1)
Form 523 Bldg. Code
APPLICATION FOR CERTIFICATE Or EXEMPTION
PLEASE PRINT OR TYPE ,, � �
1. Applicant' s Name :`\1O ( yr1 Q �U hone: Res: (Ar gQ Bus:
Address: 303 J1,J. ,C ( , City: C eeState: Wash zip :i90/�
2. Legal DescrU, ,on of property for which this "Certificate of Exemption" is being applied
for: Sectiei L
Township 5 Range
11J 1'? 0 L. Cjr:S) L Ft, a 1 Ra c -E /re)
6,-ReeNacRFs v -)\n* A 119D
3. Parcel Number (From Tax Statement or Assessor's Office) : # Q 7 7 .J 3 - {) �% a
4. Size of said property: Square Feet: Or Acres: j .
5. For which of the following reason(s) do you believe you qualify for a "Certificate of
Exemption"?:
(For each box checked, please submit the listed documentation required to substantiate
your exemption. In addition, please submit an assessor's ma and an ownership micro
run of your property, both obtainable from the Tax Assessor's Office, with your ap-
plication).
A.
B.
C.
Division of land ten (10) acres or larger
DOCUMENTS OF PROOF: 1) Assessor's map and ownership micro run as requested
above.
Minor boundary or lot line adjustments
DOCUMENTS OF PROOF: 1) Adjusted legal
agreement.
The reconveyance of old lots, tracts,
and distinct when purchased, although
contiguous.
DOCUMENTS OF PROOF:
description; 2) Copy of sales/contract
or parcels of land which were separate
the purchase thereof makes the divisions
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.
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.
❑ r.
A division of land to a spouse, sou 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.
. 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.ana i hereby agree so 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 , Sp. _.e "ourt, may withdraw any approval that
it might issue in reliance of this appli att';
ln.
"/i`'+si /_;i1;,•/..kit&I-' Date:.1=2.1L/1
NCTARY SEkl, Notary: ga /epi r, . 40.— Date: ,S / t� /26.
Signe
RECEIVED
MAY 1 G 1970
SPOKANE COUNTY
PLANNING DEPARTMENT
4. 410_
APPLICATION NO. GL-- O//2 - 775
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
en(4.. all ether infortc tio_ avJilauie, the snort :lat Administrator hereby takes the following
action on this "Certificate of Exemption" application, pursuant to the Spokane County Short
Plat Subdivision Ordinance.
^APPROVALL
- Certl r�xemption -
The Short Plat Administrator finds that a
"Certificate of Exemption" should be and
hereby is issued for said rroperty, as de-
scribed on the reverse side, pursuant to
Spokane County Short Plat Subdivision Or-
dinance Section3.3 40) .
Approval of said "Certificate of Exemption"
and issuance of building permits, shall be
subject to the following conditions:
The applicant shall comply
'u? rements and regulations
County Zoning Ordinance.
with all re -
of the Spokane
2. The applicant shall comply with KM re-
quirements of the Spokane County Health
District regarding the placement of on-
site water and/or sewage systems.
3-
4.
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 ) 6- DAY OF d�%�0� , 19-A.
sbcrt_Short Plat Administrator
SPOKANE COUNTY
PLANNING DEPART-
MENT STAMP
cvniTTfljs-
spocKOS
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.
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.
DENJ&) THIS
DAY OF
, 19
Short Plat Administrator
SPOKANE COUNTY
PLkNNfl G DEPART-
MENT STAMP