1986, 03-31 Permit App: 00011016 Residence(THIS IS NOT A PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND .3l6
COMPLETE IN INK
(Please return this original and your building plans to the Department of Building and Safety)
SHADED AREAS ARE FOR DEPARTMENTAL USE
Project Number Ile*
Owner's Name LAST FIRST MI
Tupper, Inc.
Project Address (Street Name & Number) Zip
E. 14906 Broad Ave. Spokane, Wa. 99216
Applicant
Tupper, Inc.
Address
E. 12929 Sprague
City
Spokane
State
Wa.
Zip
99216
Phone
(509 )928-1995
Business Phone
(509 )928-1995
Contractor/Agent
Tupper, Inc.
Address
E.
12929 Sprague
City
Spokane
State
Wa.
Zip
99216
Phone
(509 )928-1995
Contact
Ken or Debbie
License Number (Required)
TUPPEIR179DC
Business Phone
(509 )928-1995
Architect / Engineer
Address
City
State
Zip
Phone
( )
Contact
Business Phone
( )
Lender
Address
City
State
Zip Phone
( )
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Unbar at Dwelling units
Number of Buildings
L t Eine (Sq. Ft. Acre) -,
DepfN
Left6etbadcAter
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5
12 10 -main 10''floor
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464 3rd level unfinishedtu
720 4th level unfinished
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DEPARTMENTAL REVIEW
Approved
p
Appprrovov al
Hold
Environmental Health Permit Number
•
W. 1101 College
Room 200
❑
Planning/Zoning
N. 721 Jefferson
Permit Number
•
Engineers
N. 811 Jefferson
•
Utilities
N. 811 Jefferson
I
Plan Review/ Fire Prevention
N. 811 Jefferson
E
Other (SEPA/Critical Material/etc.)
Eii
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
Date 3 j�
1
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ADDRESS _ E. 14906 Broad Ave. STYLE
LEGAL DESCRIPTION L10 B11 SUMMERFIELD EAST 2nd ADDITION
APPLICANT TUPPER
POWER WWP
JOB # 590 WATER TRENTWOOD
FHA CASE # SCALE 1"=20'