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1980, 05-14 Permit 80-4762 MHPLAN NUMBER. .I APPLICATION/ PERMIT SPOKANE COUNTY — BUILDING CODES DEPARTMENT NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 JOB ADDRESS 1. G' J�J. LOT BLO K 2. NER i 3. . rd-nua, ADDRESS APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES SUBDIVISION 4. 5. 6. CO TRACTOR �V vY'Z ADDRESS DESIGNER ADDRESS LEGAL DESCRIPTION — SEE ATTACHED /PARCEL NUMBER/S a- , 4— el %(J�j pa-5 ')17.- 11MOP Ar7 7AL1tE-L) rElz ZIP f9z/ti PHONE ZIP Size off Parcel �7J['�'' occupancy Type Cons . Actual Set Backs in Feet North . I , G ' IEast 741 west / 60 / Zone Clastification CHANGE OF USE FROM TO PHONE ZIP Sprinklered Lies ❑No ❑ Req'd. Building Area i; Sq. Ft. %6 d VAiaation Q� d Dd© Upper Floors Garage Area Main' Floor 952d' Area of Decks Finished Basement Storage Unfin. Basement 7. TYPE OF WORK iLX MEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ❑ BLD. ❑ PLMB. 0 MECH. IUd M.H. 0 POOL 0 OTHER No. Baths No. Stories J CERTIFICATE of EXEMPTION DESCR_IB{ r,4N,ORK Enum. Dist. iLocation (Area) 8. '� .6, .,4"34-62 _ GZ4 , .,' II- I VAL ATIO�N USE CODE odd -- I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS SOURCE OF UTILITIES GAS DATE OF APPLICATION `'—Pa ELECTRIC WATER SEWER SIGNATURE OF APPLICANT-1— Ownership Public ❑ Private A. No. Rooms Req'd. No. of Dwellings Rec'd. x Not Req'd. SPECIAL APPROVALS 11 NAME DATE Env th Planning Fire Marshall Co. Engineer Utilities Plans Examiner SEPA Checklist SPECIAL CONDITIONS: "Fi, .. yi.:.i F RMAT RFQJiliED" Contact Count' Engineer's Office FEES COLLECTED Single $ Building .SW-1— Plumbing Mech. Plan Check SEPA Mobile Home Other (Specify) TOTAL $ SCy 02* *500( *50,0( rn *50.0( 6 E *0.0C 8 47612 05-14-8C 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMESA PERMIT. c c r ZiXici4 t PERMIT IS NONTRANSFERABLE PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE 0 5-1'4'=8 0 DATE ISSUED 47'6,2*50.00TV- PERMIT NO. TOTAL PERMIT NO. Spokane County Planning Department Short Plat Exemption Certificate 1. WAS THIS PARCEL SEGREGATED BEFORE MARCH 13, 1978, OR WAS APPLICATION TO SEGREGATE MADE BEFORE MARCH 13, 1978 ? (exempt under section 3.3B5 of Short Plat Ordinance) 2. IS THIS PARCEL 10 ACRES IN SIZE OR LARGER ? (exempt under section 3.3E of Short Plat Ordinance) NO YESEr/121-- 3. WILL THIS PARCEL BE USED FOR A PUBLIC UTILITY FACILITY ? YES (exempt under section 3.364 of Short Plat Ordinance) 4. IS THIS SEGREGATION BEING ACCOMPLISHED TO EFFECT A MINOR BOUNDARY OR PROPERTY LINE ADJUSTMENT, BUT NOT CREATING ANY NEW LOTS OR CAUSING OTHER LOTS TO FALL BELOW MINIMUM ZONING STANDARDS FOR SIZE SHAPE OR FRONTAGE, OR AFFECTING ROAD ACCESS TO ANY OTHER LOTS ? (exempt under section 3.3H of Short Plat Ordinance) 5. IS THIS PARCEL ZONED RESIDENTIAL OFFICE, LOCAL BUSINESS, COMMERCIAL, FREEWAY COMMERCIAL, INDUSTRIAL OR MANUFACTURING ? (exempt under section 3.3B4 of Short Plat Ordinance) APPROVED BY: F 2civ YES YES DATE: vim/ /Z / 80 I hereby certify the answers I have offered in connection with obtaining this exemption are true APPLICANT'S SIGNATURE: DATE: / / J r r N I NI bU r (11141. N ). 1 it litHSON SIKEEI SPOIPANt WA5111NI, I UN 991b0 ✓1 I Nt 4]b lLr 12D44-UJOD BLACK 7aL0250109 E H HERITAGF 01/31/74 TAX PAID FIRE IMPROVED UNIMPROVED i OTAL LAND I MPR. ACRES ACRES VALUE ACRES VALUE ACRES VALUE VALUE VALUE YR EX C0[)E 7 000 7000 B0 140 7000 7000 81 140 GRNACRS IRR DIST A PT Or B 1 3 BEG AT SECOR B13 TH SB9D G 70J0 7000 44 yl I N A ALO SL 56u. 6o}-T TH id l oDEG OoMIN 3USDS E250. l 9-T TO P i Or CURVE TH CUPV TO RIGHT RADIUS OF 945.37rT 1-OP o 10.43t-T TO EL Or SD B13 T. i SODEG 1 7M I N 3050S E633kT 10 POB 2D-l90 pRDPOSE I� 14001l fed N /AU)/ A n/4 A 1/. "