1978, 09-05 Permit App: N0442 Residence LY / O
0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE .___/r?�� ---
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. 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.
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.
LICANT FILL IN BELOW THIS LINE �'l%�G�
Name of Owner A — / /iZ-/ Address L lv�-s % Phone "--.57 ./
Architect A/Ai /�� Address Phone
Engineer ,U/C Address / Cyixe/ PhoneContractor Address e y Pho e —83p--, ,i/
Legal Description of Property (Give complete description from deed, tax receipt, etc.) Parcel Number 265 / �
SCJ /.id ' et/W/5- i 4/ _24 --,21 --/7.5 � ' /V ,A' -
-th '1/ c Yl '21/. � �.{z- >> S '7
RAY VIII'
DESCRIPTION OF • • .)levy �� Addition 'Remodel- Moving Bldg. Zon / Fire a '3
Size of Lot /e ' 1 -5'.X //Y /X r7 _0(1(1_4 Spyvage System -e-ti Cons 6
L q /v X/L / . Xd� IFr., Conc fj- ./J lie
Stories Dimension/ v� 9 / )(2L A-L" dotal Sq. Ft. Valuation /1��
Rooms -8 Baths��� Basem: t I ./ Foundation Const. (- 1-'E,6f Chimney (Kind Firepl c�N bier /,�
r/E/�Fu/il`/ art, n. ► L!� �2 C•}BCL�I'
Heat. Systeme �n0 fr-4Type of Roofing "....[ J i�t�<<'v ���% Int. Wall Finish
Use of Bldg. A_(' l �- L 9d4/I C / l/ No. of Unit Bedrooms
PLOT PLAN 70
ons
Draw sketch with dimensions showing: (1) property lines; (2) street or road loca ; ( ) 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.
NORTH State Lic= se No.
.r A
IAI•s, ct. No.
,2)14, /r616
SIDENTIAI,.–COMMERCIAL
..1)
REQUIRED
Plumbing Permit
n• Heating Permit
•* a
us N Sewage Permit
-4 " -•
a
Plans Received
* Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
1
SO TH
Ohereby certify infor,- ion sub. tt•d is correct and there are no other structure. located on this property except
as sh .._ b, \--..... - ' , r _ At, 1- /2'6
/
Owner or Agent Date
A LA D SE OR STRUCTURE PERMIT UST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS I OT A PERMIT.
A, �'�/' ) DO NOT WRITE BELOW THIS LINE `J-1/---'1 L Y
Your street address will be E, SYOq /� G L� 7 The zone is 2
Sewage Permit Number Issued Building Permit f• Receipt ,T-SI� Issued
Remarks
I
Form 523 Bldg. Code
41 ,_ --
010 , 1
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APPLICATION FOR CERTIFICATE OF EXEMPTION
PLEASEPRINT OR TYPE
,1 __Applicant's Name . Phone: Res:
. 4'
--9g Bus: 7
._Address Lr- - City. k C , State: ZIP: l2.03
2. Legal Description of property for wh .ch this "Certificate of Exemption" is being applied
for: SectionAh Township 5 Range , L3
,,-__t^^ `- \__ __r ts0 t6 .E. tkk€ - .f tb `reci ►'D R4-1.3
1/1 ii
La. _V u K -5 A
3. . Parcel._Number_ (From Tax Statement or Assessor's Office): # a 6531 .9
4. Size of._said._property: Square Feet:[ Or
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 Maud au o ership 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 CF PROOF: 1) Assessor's map and ownership micro run as requested
above.
0 B• . Minor boundary or lot line adjustments
DOCUMENTS OF PROOF: 1) Adjusted legal description; 2) Copy of sales/contract
.� � agreement .
i "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
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.
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.
0 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 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
it might issue in reliance of this appl cation.
Signed: T-... Date: k 131_.._
NOTARY ; ,-', Notary: _ Date: 8 / 3 ' /78
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APPLICATION NOfit-- `�
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SPOKANE COUNTY =a®ORT PLAT SUBDIVISIC'ti`"ORDINANCE
NOTICE OF ACTION ON CERTIFICATM Cr EXEMPTION APPLICATION
Whereas, the Board of County, Oommissiopers did, after public hearing on March 9, 1978, adopt
the Spokane County Short Flat Subvisin 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 Flat Administttor has received a request for a "Certificate of Exemption"
for certain property located -in the unincorporated territory of-the County of Spokane; and
A
Whereas, the Short Plat Administrator has reviewed the evidence presented by the applicant
and all other information available, the Short Plat Administrator hereby taken the following
action on this "Certificate of Exemption" application, pursuant to the Spokane County Short
Plat Subdivision Ordinance.
-—OVAL DENIAL
Certifica e o emption - - Certificate of Exemption -
The Short Plat Administrator finds that a The Short Plat Administrator finds that a
"Certificate of Exemption" should be and "Certificate of Exemption" Should not and
hereby is issued for said property, as de- hereby is not issued for said property as
scribed on the reverse side, pursuant to described on the reverse side, pursuant to
Spokane County Short Plat Subdivision Or- Spokane County Short Plat Subdivision Or-
dinance Section j.25, 5.1,3..Sf31 dinance Section , for the follow-
Approval of said"Certificate of Exemption" ing reasons:
and issuance of building permits, shall be
subject to the-fellowing conditions: 1 .
The-applicant shall_compl__with all 'e-
quirements and regulations of the Spokane
County Zoning Ordinance.
2.
0 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.
3.
According to the Spokane County Short Plat
4. 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.
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 „3/ DAY OF ard", 19 ,. DENIED THIS DAY OF , 19
d S• % Plat-A inistrator Short Plat Administrator
SPOKANE C•'1 :' NE " ILM:180GN
FFsEESPOKANE COUNTY 'n%r�PLANNING DEPd •-• Th " 9RMENt PLANNING DEPART-
MENT STAMP SPOKANE,WAS MIT STAMP r
,
.77
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THIS CERTIFICATE -
MUST ACCOMPANY
YOUR BUILDING P sMIT APPLICATION r;
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PLOT PLAN
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