1979, 06-15 Permit App: N3661 Residence Cow / of Spokane, Washir \on
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99260
di 01
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 7ccd
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 THIS LINE r PF��a-C y'gin/(d
Name of Owner" _ .�./�. '' Address•." .A1pat-7.4,41,,,,,t _ Phone 9�—4 /:9
Architect .. _ Address - Phone
Engineer_ Address Phone _
Contractor '4J .i4•L/ Address. Phone
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel NumberZ.2%.3--51/— 'Y ' 7
Tom .- c�" /I �. .JEMMY ♦ -- --
DESCRIPTION OF WORK: New X Addition Remodel Moving Bldg. Zone / Fire one ‘7.-1c
Size of Lot 2"7, T � X / D Sewage Systemonst. -a.4-L -
f
�i Fr., Conc., Br., etc.) a 0Stories ' Dimensions 01..-673C 31At)(LP 0,: e` Total Sq. Ft. 4J36 /�luation o
Rooms-- Baths Basement ! Foundation Const. Chimneyf Fireplace 1�
(Full, part, none) (Kind)
Number
Heat. System'17. :3 Type of offing Ext. Finish %�'//1 Int. Wall Finish 1.1
Use of Bldg. ,it,Q,v Lei ,,i C'r- t/ 1. G r No. of Units Bedrooms 'f
ROADWAY R/W WIDTH- 4c' f
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.
..5DGI/%
NORTH State License No.
Ina. Ins. Acct. No.
ESIDENTI L- COMMERCIAL
REQUIRED
Plumbing Permit
R rn Heating Permit
in O
\ N Sewage Permit
• ( 1 Plans Received
y Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
SOU TH_..__ A k/. .
Il/ RTX
I hereby certify-information submitted is correct and 'mere are no other structures located on this property except
as shown.
Ownerfor Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOTA PERMIT. PERMITS ARE NON-REFUNDABLE AND NON-TRANSFERABLE
DO NOT WRITE BELOW THIS LINE 36
Your street address will be /:3-06 j r ( se zone is C/ c/TiL a/C
Sewage Permit Number Issued _ Building Permit 1..— - Receipt I" Issued
Remarks ...ma'
- _ / s-s p- a
-- ���• C/A)--1/4 9
e
N4.,: a -.W,
APPLICATION FOR CERTIFICATE OF EXEMPTION
APPLICATION FEE - $5.00
PLEASE PRINT OR TYPE
1 . Applicant's Name: PAUL R. BEMIS Phone - Res: 922-0162 Bus:
Address: N. 4.008 LYNDEN City: SPOKANE State:WASH ZIP: 99216
2. Legal Description of property for which this "Certificate of Exemption" is being applied
for: Section 22 Township 25N Range 4EWN
THE WEST 87.5 FEET OF THE EAST 282.5 feet of the srn]th 112 fPPt of the north 132 feet 1
of the southwest quarter of the northeast quarter of section 22, tnwnship 25 north t
range 44 EWM
3. Parcel Number (From Tax Statement or Assessor's Office: # 2254.1-9047
4. Size of said property: Square Feet: 9800 sq ft Or Acres:
5. Intended use of said property: CONSTRUCTION OF ONE SINGLE FAMILY RESIDENCE
6. Zoning of said property: AGRICULTURAL
7. For which of the following reason(s) do you believe you qualify for a "Certificate of
Exemption"?: D&F
(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 application .
— A. Division of land ten (10) acres or larger 1
DOCUMENTS NEEDED: (1) Assessor's map and ownership micro run as requested above. i
B. Minor boundary or lot line adjustments
DOCUMENTS NEEDED: (1 ) Adjusted legal description; 2) Copy of sales/contract
agreement.
C. The reconveyance of old lots, tracts, or parcels of land which were separate and 1
distinct when purchased, although the purchase thereof makes the divisions
contiguous. 1
DOCUMENTS NEEDED: (1 ) Copy of tax statement; 2) Copy of deed or dated copy of
sales/contract agreement
(D Division of land created prior to March 13, 1978 #
r R
E. Division of land for the purpose of housing public utilities facilities )
F
r�..,��1
The purchase of one separate and distinct parcel of land prior to March 13, 1978 i
DOCUMENTS NEEDED: (D Copy of deed or dated copy of sales/contract agreement. 1
i
G. A division of land to a spouse, son or daughter
DOCUMENTS NEEDED: (1 ) Copy of deed/Quit Claim Deed or dated copy of sales/contract`
agreement. 2) Notarized affidavit attesting to said
relationship
H. A division of land within properties zoned Residential Office, Local Business,
Commercial , Industrial , Manufacturing, or Freeway Commercial
DOCUMENTS NEEDED: (1 ) Copy of survey
8. Additional comments which may substantiate your qualification for an exemption:
i
I , the undersigned, swear under the penalty of perjury, that the above responses are made I
truthfully and to the best of my knowledge. I also agree to furnish any further documenta-
tion 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 information a
is required. I also understand 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.
5
SIGNED: /'/ /
146_-/r1. ,I DATE: 5 / /y/ 77 t
NOTARY: / ' A /J� _ DATE: c / 01 "7 1
NGTARY SEAL
L
ECEIVE D ,
a
WIRY 14 1979
SPOKANE COUNTY
APFLI :AT: ON NO. It 5 - 7 ,
SPOKANE COUNTYrSHORT PLAT SUBDIVISION ORDINANCE ,,`
NOTICE OF ACTION ON CERTIFICATE OF EXEMPTION APPLICATION
Whereas, 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 release
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.
s1('-
APPROVAL ) DENIAL
(77—C—e—r—ti—a—t—e-of Exemption - - - Certificate of Exemption -
The Short a tutor finds that a The Short Plat Administrator finds t at a
"Certificate of Exemption" should be and here- "Certificate of Exemption" should n t and here-
, by is issued for said property, as described by is not issued for said property as described
on the reverse side, pursuant to Spokane on the reverse, side, pursuant to S okane County
County Short Plat Subdivision Ordinance Short Plat Subivision Ordinance ection
Section i FU& -5)toy 9L1 mz6 /r d/&!e)T1r/-. , for the following /reasons:
Approval of said "Certificate of Exemption" 1 .
and issuance of building permits, shall be
subject to the following conditions: '
\1
1 . The applicant shall comply with all require r
ments and regulations of the Spokane County :
Zoning Ordinance. l
2. The applicant shall comply with all require J/
J
ments of the Spokane County Health District j'
regarding the placement of on-site water
and/or sewage systems.
3. ahs- ..Q �oZrM / w>,4 A \\\ k
(31)p n c N...4o i i
/leg ` According to the Spokar� Couty Short Plat Sub-
,' I j
' . �/�'` division Ordinance, th- division of land that
you propose to develo4 is defied as a Short I
Plat and you will be required t• comply with
the requirements of said Ordina e prior to
issuance of buildi • permits.
This "Certificate of Exemption" is and shall
run with the land and shall be applicable to
the applicant, owner, their heirs, successors,
or assigns.
APPROVED Ty I SAsi"DAY OF J�i91 1929DEN i ED THIS _ DAY OF , 1 S • .
,r1,,/e/,,x‘747,,fzu
S ort Plat Administrator Short Plat Administrato
SPOKANE COUNTY SPOKANE OUNTY
PLANNING DEPART- PLANNING DEPART-
MENT STAMP MENT STA1 P
f
11
,THIS CERTIFICATE MUST ACCOMPANY
YOUR BUILDING PERMIT APPLICATION