1986, 03-31 Permit App: 00011019 Residence—t
(THIS IS NOTA PERMIT)
BUILbING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND /;
COMPLETE IN INK Iy
(Please return this original and your building plans to the Department of Building and Safety)
SHADED AREAS ARE FOR DEPARTMENTAL USE
Project Number /,D ,'Q
Owner's Name LAST FIRST MI
TUPPER INC.
Project Address (Street Name & Number) Zip
E. 14913 Broad Ave. Spokane, Washington 99216
Applicant
TUPPER INC.
Address
E. 12929 Sprague Ave.
City
Spokane
State
Washington
ZIG
99216
Phone
(509 )928-1991
Business Phone
(509 '928-1991
Contractor/Agent
TUPPER INC.
Address
E. 12929 Sprague Ave.
City
Spokane
State
Washington
I Zip
99216
Phone
'509 '928-1991
Contact
Ken or Debbie
L,cense Number (Required)
TUPPEIR179DC
Business Phone
(509 '928-1991
Architect / Engineer
Address
City
State
Zip
Phone
Contact
Business Phone
I ?
Lender
Add ess
City
_
State
Zip
Phone
(
.._ """!�,�." —lass.
Oaavor
SkDbdiFatiotmiPiet
Comm.
,s Name/Short Plat Plumber �� 4j� 6 Z /94e77G;LJ /l i�i (ice
SUMMERFIELD EAST 2ND ADDITION
Pj .et Nhinaer
Lot
7
Block
10
Plat Number
i-tinent t=ile Numbers
Zone
Comp. Plan
Census Tract
Number of Dwelling Units
1
'Front
Number of Buildings
1
Lot Size (Sq. Ft./Acre)
11,135
Depth
Frontage
Setback
Left Setback
Right Setback
Rear Setback
Additions information
996 main floor
DEPARTNIENT USE
Square Footage
948 basement - unfinished
484 garage
100 uncovered deck
4
k
'.Building
Technician
Date
Group
Type
g
r
DEPARTMENTAL REVIEW
Approved
Cond.
Approval
Hold
Environmental Health Permit Number
•
W. 1101 College
Room 200
E
Planning/Zoning
N. 721 Jefferson
Permit Number
Engineers
N. 811 Jefferson
❑
Utilities
N. 811 Jefferson
IMINIM1111.1•101.1101MOIMIIIIIPT
Ei
4111111111111111110•11111•11M
Plan Review/Fire Prevention
N. 811 Jefferson
J
Other(SEPA/Crlticaf Material/etc.)
E
Fast Track/Special Inspection Information
Project Representative
Phone
Address
1 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 7 `�--
-7
•
--
I
Bt.
- r..
0
meee
ADDRESS E. 14913 Broad Ave.
STYLE
LEGAL DESCRIPTION L7 B10 SUMMERFIELD EAST 2nd ADDITION
APPLICANT TUPPER
2200-D
JOB # 588
FHA CASE #
POWER WWP
WATER TRENTWOOD
SCALE 1"=20'