1986, 03-31 Permit App: 00011017 Residence(THIS IS NOTA PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
COMPLETE IN INK 2`'-,56
(Please return this original and your building plans to the Department of Building and Safety)
SHADED AREAS ARE FOR DEPARTMENTAL USE
111
I Project Number / /Or/
Owner's Name LAST FIRST MI
TUPPER INC.
Project Address (Street Name & Number) Zip
E. 14907 Broad Ave. Spokane, Washington 99216
Applicant
TUPPER INC.
Address
E. 12929 Srpague Ave.
City
Spokane
State
Washington
Zip
99216
Phone
( 509) 928-1991
Business Phone
( 509) 928-1991
Contractor /Agent
TUPPER INC.
Address
E.
12929 Sprague Ave.
City
Spokane
State 1
Washington
Zip
99216
Phone
( 509) 928-1991
Contact
Ken or Debbie
1 License Number (Required)
1 TUPPEIR179DC_
Business Phone
( 509) 928-1991
Architect / Engineer
Address
City
State
Zip
Phone
( 1
Contact
Business Phone
( )
Lender
Add ess
City
State
Zip
phone
( 1
SFR
bd, irtatnefetert Plat number 3�6 444q6' 7_5 -
:_SUMMERFIELD EAST 2ND ADDITION
Assessor Parcel Number
Lot
8
`Block
10
Plat Number
Pertinent Fite Numbers
Zone
Comp. Plan
Census Tract
Number of Dwelling Units
1
Number of Buildings
1
Lot Size (Sq. Ft./Acre)
11,135
bepth
Frontage
front Setback
Left Setback
Right Setback
Rear Setback
Additional Information
1258 main floor
ENT USE
Square Footage
752 unfinished basement
451 garage
11-
m
a
W
0
Building Technician
Date
_
Group Type
t
DEPARTMENTAL REVIEW
I certify that 1 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 2f
Approved
Cond.
Approval
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
Plan Review/Fire Prevention
N. 811 Jefferson
Other (SEPA/Critical Material/etc.)
Fast Track/Special Inspection Information
Project Representative
Phone
Address
I certify that 1 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 2f
,
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7 7 ,
t. •
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ADDRESS E. 14907 BROAD AVE. STYLE 1200
LEGAL DESCRIPTION L8 810 SUMMERFIELD EAST 2ND ADDITION
APPLICANT TUPPER
JOB # 589
FHA CASE #
PERMIT #
POWER WWP
WATER TRENTWOOD
SCALE 1" = 20'