1985, 10-04 Permit App: 00008019 Residence(THIS IS NOTA PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
COMPLETE IN INK
(Please return this original and your building plans to the Department of Building and Safety)
SHADED AREAS ARE FOR DEPARTMENTAL USE
I Project Number
Owner's Name LAST FIRST MI
TUPPER INC.
Project Address (Street Name & Number) Zip
E. 14821 Broad Ave.,Spokane, Washington 99216
Applicant
TUPPER INC. -
Address
E. 12929 Sprague Ave.
City
Spokane
State
Washington
Zip
99216
Phone
(509 ) 928-1991
Business Phone
(509 ) 928-1991
Contractor/Agent
TUPPER INC.
Add ess
E. 12929 Sprague Ave.
City
Spokane
State
Washin ton
Zip
99216
Phone
(509 ' 928-1991
Contact
Ken or Debbie
License Number (Required)
TUPPIER179DC
Business Phone
(509 ' 928-1991
Architect /Engineer
Address
City
State
Zip
Phone
( I
Contact
Business Phone
( 1
Lender
Address
CI',.
State
Zip
Phone
( 1
i• :e alii i l y' Residence
Mies..
tAorrmk.
' lP t NalilefShort.Plat Number
U►4l<1ERFIELD EAST FIRST ADDITION
Parcel Number
5644-2$22
22
8 .
Plat Number
11n itrnent Fite frgtmbers
Z ne
Comp. Plan
Census Tract
*umbar of Dwelling Units
I.
Number of Buildings
1
Lot Size (Sq. Ft./Acre)
12,269
Depth
130.00
Frontage
75.00
irrart Setback
Left Setback
Right Setback
Rear Setback
AciditionaiInformationSSquareFootage
`
1258 main floor G{Hf,, -3-6.06
to
Rout t,
/.:730 unfinished basement ci('$ i , 00
"566,.C9C)
528 crawl space /�,
441 garage 1024tli
1.'S
fi,50
°Ccx baa 3 S 4..50
z
111
2
cc
a.
AS• C)
322.50
Built;
,
la y/��
-�
Type
DEPARTMENTAL REVIEW
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent is true, correct, legal, and binding.
Owner's Signature
717
Date
Approved
Cond.
Approval
Hold
Environmental Health Permit Number e.5.--,)--/-3
W. 1101 College
Room 200
/
Planning/Zoning
N. 721 Jefferson
Permit Number
/o— 8
Engineers r�
N. 811 Jefferson "' r A' --4 3 Q
Utilities
N. 811 Jefferson
I
Pian Review/Fire Prevention
N. 811 Jefferson
%d -7A
/I)
Other (SEPA/Critical Material/etc.)
Fast Track/Special Inspection Information
Project Representative
Phone
Address
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent is true, correct, legal, and binding.
Owner's Signature
717
Date
1
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575
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ADDRESS E. 14821 Broad Ave.
LEGAL DESCRIPTION
STYLE HOME Rancher 1 OO
L22 B8 SUMMERFIELD EAST FIRST ADDN.
APPLICANT TUPPER INC.
JOB NO. 560
FHA CASE NO.
POWER W.W.p.
WATER TRENTWOOD
SCALE 1"=20'