1986, 03-31 Permit App: 00011044 Residence(THIS IS NOT A PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET L/31 a'
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
' Project Number /1614
Owner's Name LAST FIRST MI
Tupper, Inc.
Project Address (Street Name & Number) Zip
E. 14925 Broad Ave. Spokane, Wa. 99216
Applicant
Tupper, Inc.
Address
E. 12929 Sprague
City
Spokane
State
Wa.
Zip
99216
Phone
(509 )928-1995
Business Phone
( )
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 I
Zip
Phone
( )
Contact
.
Business Phone
( )
Lender
Add ess
City
State
Zip
Phone
( )
Hila illama# stagnat Nur/lber 5 I1WO ,/`'li 7761 1 `j , '..P E / '
-yfitu7urterf j.e1.d Fast Ind Addition
Assessor Parcel Number
Lot
5
Block
10
Plat Number
msmf Fit s Numbers
---/. ^t.
Comp. Plan
Census Tract
ligtmberofMeiling Units
1
Number of Buildings
1
Lot Size (Sq.�Ft./Acre)
11,089
Depths I
I
Frontage
51--- 72
prat_Setbaekfm
- 3oboo?
Left Setback (
Right Setbackr
Rear Setback
,.
-
i�drlIlona, .mformation
1236 ' Fla ip floor finished
ARTMENT USE
Square Footage
3rd 1eve1 finished
.324
546 4th level unfinished
484 garage•
a
-Building Technician
Date
Group
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 `Z 7 e17-�`& --
Date -��� 6
Approved
Cond.
Approval
gold
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
i
Other (SEPA/Critical Materlal/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 `Z 7 e17-�`& --
Date -��� 6
ADDRESS E. 14925 BROAD AVE. STYLE 3200/4th
LEGAL DESCRIPTION Lot 5 Block 10 SUMMERFIELD EAST 2nd ADDITION
APPLICANT TUPPER INC.
JOB # 586
FHA CASE
POWER WWP
WATER TRENTWOOD
SCALE 1" = 20'