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1978, 09-12 Permit App: N0607 Residence6� Cour of Spokane, Washin n BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGAPPROVED AS NOTED 14uNkan9 unty Bldg. Code Dept. APPLICATION FOR LAND USE OR STRUCTURE MRMIT ,50 GENERAL REQUIREMENTS Pr 4IT F or structure already erected, or to change a land use. Construction must conform with the Spokane County Building C 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 performea 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 THIS LINE PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or struck Name of Owner .11 • i - ..'tet /LA/ Architect . Engineer Contractor,,gd.a' ff Address Address Address Address Phone Phone Phone Phone Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number 6 76-67- ©�� DESCRIPTION OF WORK: New___,__ Addition Remodel Moving BI.g. Zo e _1_ Fire one3 Size of Lot Sewage System 1, ... onst. r / / (Fr., Conc., Br., etc. -:. k* Dimensions 3AVJLt7 ,c .241k O..J. i n .,"- AEC K Total Sq. Ft.� 2�S/ �'o/a oo GD 4� Valuatio Rooms_k_ Baths_ Basement �l2 Foundation Const. -CiiQ i Chimney 1 e aced! (Full, part, none) (Kind► (Num4er Int. Wall Finish No. of Units Bedrooms Heat. System Use of Bldg. ROADWAY R/W WIDTH 6O Ext. Finish i It /�� 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 to NORTH 320' ?/L N/ .z82' p,PP PILOPOSED RESIDCN CE 30' 390 ' P/L SOUTH State License No. nWNFR Ino. Ins. Acct. No. �RESTD &1 - COMMERCIAL REQUIRED Plumbing Permit rn Heating Permit Sewage Permit Plans Received Plans Checked Plans Returned Plans Picked Up Plans Mailed y/i2fon t I hereby ce tify information submitted is correct and there are no other structures ocated on this p operty except as shown. /v % ,.1. _ _ ‘5F -1-X-125`117457. Owner or Agent Dat e A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES. THIS IS NOTA PERMIT. PERMITS ARE NON-REFUNDABLE AND NONTRANSFERABLE DO NOT WRITE BELOW THIS LINE G 6 Your street address will be Sewage Permit Number Issued Remarks ' A-kk DUILi2%N6 S -- -J2 - 7 e zone is MRd1GLtLTUML,_ Building Permit Receipt „s' n_ Issued 11,2— Lfs L -7 u p z CTAND Form 523 eddy. Coda APPLICATION FOR CERTIFICATE OF EXEMPTION PLEASE PRINT OR TYPE vv v 1. Applicant's Name jta<'be11 /%) /(YG7.S/7.�C,4q Phone: Res:' U4/50 Bus: Address: ,'. J:> ank.ki`cA City: Spkir,e State: 414517 ZIP: eiy,206 2. Legal Description of property for which this "Certificate of Exemption" is being applied for:unSection 7 Township 9.S Range /3 l-� r een QCr-.3 .7Trr as A ,V /.20 i. of S. ,?).e);2 D( ? S/ 3. Parcel Number (From Tax Statement or Assessor's Office): # © 755 % - C7/ S 2 4. Size of said property: Square Feet: pra/ 542cx Or Acres: To u: /c a e c,) 5. Intended use of said property: ko S . e�ilz�,'c, / • 6. 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 map 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. 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. D• m TS OF PROOF: 1) Copy of tax statement; 2) Copy of deed or dated copy of sales/contract agreement QD. 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. 0 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. ETF. 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: 1, 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 :Lnfor - . 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: fin. /r LL Date: -1.,-f2 /4" ' 4: :- Date: r / / % 'RECEIVE SEP 71971 SPOKANE COUNTY PLANNING DEPARTMENT !PA? APPLICATION N0. `E- "D rra. • 14,e, SPOKANE COUNTY SHORT PLAT SUBDIVISION ORDINANCE NOTICE OF ACTION ON CERTIFICATE OF EXEMPTION APPLICATION Whereas, the Board of County Commissioners did, after public hearing on March 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. 9, 1978, adopt - C 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 Platubdivi o Or- din_ance Section 3.3 B 3'itCwSs• 1 Z!O Approval of said "Certificate of Exemption" and issuance of building permits, shall be subject to the following conditions: () The applicant sba11 comply with all re- quirements and regulations of the Spokane County Zoning Ordinance. fei) 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. • 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 /X DAY OF 192E. SPOKANE COUNTY PLANNING DEPART- MENT STAMP t Plat Administrator TS 'd'RTTFTCATE MUST ACCOMPANY 1=_puILDING PERMIT PPLICATI DENIAL - Certificate of Exemption - The Short Plat Administrator finds that a "Certificate of Exemption's 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. DENIED THIS DAY OF, 19 Short Plat Administrator SPOKANE COUNTY PLANNING DEPART- MENT STAMP