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1986, 03-31 Permit App: 00011043 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) onnvcv nn�no nnt= rvn ut=rr%n i mcf 1 mu vor= Project Number / / O ikg Owner's Name LAST FIRST MI Tupper, Inc. Project Address (Street Name & Number) Zip E. 14924 Broad Ave. Spokane , Wa. 99216 Applicant Tupper, Inc. Address E. 12929 Sprague City Spokane State Wa. Z:p 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 ( 1 Contact Business Phone ( ) Lender Add ess City State Zip Phone ( 1 :- { .. ,wt wan.rriirm JYwstk+3e1911t , Plat Number :./9k�" erfedeast 2nd Additiorn k e 't�a.:M cet . 7 11 Number PerNInent File Numbbera mrt. Comp_ Plan Census Traps Number of Dwelling Units . 1 Number of Buildings 1 Lot Size (Sq. Ft./Acre) 11,200 ' 1 140 Frontage t fLeft Setback jl t R ►t Setback t Additlo ai tnfarrnattbrt 1258 main floor 'ENT USE Scidars 752 bsmt. unfinished 451 garage tc a.w�( ,� .[ f,�'}N+�..�{'� � vY. .,.+.e,, .... ,. �n. ..w.. �•.. e.. ... r ..., ., ' e d ., ,.,ro .l ,. .. V.. ...x�5t.. �t '6N'vl; ... C .....t.3aT,l,. .,» � .'•ya.,..TM4i; 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 Date �` 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 I Pian Review/Fire Prevention N. 811 Jefferson Other (SEPA/Critical Material/etc.) Fut 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 �` fCT • 10 00 < + "°4 I L' 9' 7x00 GAL-- • p A00 '_dka+d o' . FL©Coe 30.0 G-Itlei +ea" ,41 "1 1 COgGrrEG. r.04 3ri0N AVE ADDRESS E. 14924 Broad Ave. STYLE 1200 LEGAL DESCRIPTION L7 B11 SUMMERFIELD EAST 2nd ADDITION APPLICANT TUPPER JOB # 593 FHA CASE # PERMIT # POWER WWP WATER TRENTW00D SCALE 1"=20'