1978, 05-30 Permit App: M6520 Residence4
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
�., APPLICATION FOR LAND USE' OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE.7
IT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of en!
Mu 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.
RATER. 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 Noss. 45133 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
dee
Name of Owmer N1 77 4/,Air Address S 1 703 BOLA V AIR_ Phone q 2,4 4 9 ZZ
Architect Address Phone
Engineer Address Phone
Contractor N) 7' t. (t-bN CT. Address wS 1703 Bo L3 uAR phone ea 24 St /91L2.
Legal Description of Property (Give complete description from deed. tax receipt. etc.) Parcel Number 7.P.1.4 -142-
L 07- e AND WEST /S- �.T or &or /9 ,p.3LK'R — Lr1_QOt'7/,Awit 14th
pia/ 6F PAR('FL# aVSi1-03ao
DESCRIPTION OF WO/NP "New Addition Remodel
Size of Lot 6S—OX /are' -U"
Stories ) Dimensions.2 9y X 4S'
Rooms Baths / Basement FULL Foundation
(Full. part. none)
Heat. System Pf E, l..Be Type of Roofing Co "AP.
Use of Bldg. C r CL.E rAM Q (c,5&e Pk/ vi-
s 9--t2S-"Rse3
Moving Bldg. Zone / Fire Zone 3
Seamge SystemSE9f7c fAAIMonst.
(Fr., Conc.. Br, etc.)
Total Sq Ft /6 .56 Valuation <Br<.,one
Const. eo.t n . Chimney (Kind)
Fireplace
Number
Ext Finish C.JAbwoob Int Wall Finish 9RyauALL.
No of Units L Bedrooms 3
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.
cm
H
NORTH LS
6Z'
SOH Vs IV/NTT/ AVS
State License No.
MltA4i-ntit-aa36PAS
Ind. Ins. Acct. No.
RESIDENTIAL — COMMERCIAL
REQUIRED
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
I herebjyy cert fy information submitted correct and there are no
•ELS ehywn. yyi /.'fear
o%
Owner or gent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.�I,
(9. v 4/14
other structures 1 ated o this property except
�7
Tour street address w111 be
Sewage Permit Number Issued
Remarks
DO NOT WRITE BELOW THIS LINE
Building Perini
V
form 5T3 Bldg. Cods
1Te zone is
ReceiptIs ed
rir
•
APPLICATION NO.
SPOKANE COUNTY SHORT PLAT SUBDIVISION ORDINANCE
NOTICE OF ACTION ON CERTIFICATE OF EXE2PTION 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 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 Ordirance.
,APPROVAL)
- Certificate' of` 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 3311
Approval of said "Certificate of Exemption"
and is uaT:ce of buil _rg :e: mics, shall be
subject to the following conditions:
1. The applicant shall comply with all re-
quirements and regulations of the Spokane
County Zoning Ordinance.
2. 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.
3.� }tu 0;p420- eli.�-.macO1.tecord
i at Coma .
Q Q-oo
4. CFte 4�2p�iC:�..� ,,/� e-
ue i ort = Zl�i s a y�-001 i �`c4m
vs 4cAreicul -t
cue de u �t sc� s cam.¢ .. i o pp,Lie ta• S m.% c e/CAA-0/00 retie
This "Certificate of Ex4tnption" is and shall
run with the land and aha11 be applicable to
the applicant, owner, their heirs,
sors or assigns.
u tti ltioct4
�J
APPROVED THIS DAY OF
succes-
9 -A:-
co-Short Plat Administrator
SPOKANE COUNTY
PLANNING DEPART-
MENT''P01:0E COUNTY PLANNING DEPARTMENT
NORTH 811 JEFFERSON STREET
SPOKANE, WASHINGTON 99201
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:
2.
3.
According to the Spokane County Short Plat
eu ubdivision 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
1
APPLICATION FOR CERTIFICATE OF EXOIPTION
PLEASE PRINT OR TYPE
1. Applicant's Name: ,V, T ,L/ (`!4AiS7'i'"re>n4,,, Phone: Res: Cf.26; /92.2? Bus: -34/rr
Address: S I `70"" iR,-�a.-40Aa City: CJrnA-- State: &)1.4 ZIP:919'6)3/
Legal Description of property for which this "Certificate of Exemption" is being applied
for: Section 'Township &5. Range `,R
�uEST
_AL
n -r / S' A n! i) n -f P / 5 FT e) r J- / 7 , R I -K _ - 6:.: 60-b LAWA/
13. Parcel Number (From Tax Statement or Assessor's Office) : 37
4. Size of said property: Square Feet: 6-s-')( /36:
Or Acres:
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 map and an ownership micro
run of your property, both obtainable from the Tax Assessor's Office, with your ap-
plication).
DA. Division of land ten (10) acres or larger
DOCUMENTS OF PROOF: 1) Assessor's map and ownership micro run as requested
above.
E B.
D
Minor boundary or lot line adjustments
DOCUMENTS OF PROOF: 1) Adjusted legal description; 2) Ccpy of sale /contract
agreement.
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
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.
l0 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 famish 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 applicat'„y,.�
iii G� /g
r
NOTARY SELL
J .z
Signed:
N;a ty:
liRrNr f!r
Date: C. `
Date: v /
/4