1986, 03-31 Permit App: 00011046 Residence(THIS IS NOTA PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
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COMPLETE IN INK 4i5/,
(Please return this original and your building plans to the Department of Building and Safety)
SHADwD AREAS ARE FOR DEPARTMENTAL USE
1 6 Project Number i�
Owner's Name LAST FIRST MI
TUPPER INC.
Project Address (Street Name & Number) Zip
E. 15010 Broad Ave. Spokane, Washington 99216
Applicant
TUPPER INC.E.
Address
12929 Sprague 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
Washington
Zip
99216
Phone
(509 )928-1991
Contact
Ken or Debbie
License Number (Required)
TUPPEIR179DC
Business Phone
(509 )928-1991
Architect /Engineer
Address
City
State
1 Zip
l
Phone
( )
Contact
Business Phone
( )
Lender
Add ess
City
State
Zip
Phone
i )
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Comm.
ry _ aefs Number 4/4/9G7,5" ' "GiC7I() i'3S1r -.E' e% �
SUMME-RFIELD EAST 2ND ADDITION
Assessor Pan ei Number
tot
5
Stock
11
Ptat Number �y
Pact'neat File Nnimtiera
Zww
Comp. Plan
Census Tract
tiurnber of Dwelling Units
1
Number of Buildings
1
Lot Size (Sq. R, /Acre)
11,291
Depth
//- '2 /
Frontage
%-
Fiat SetbackO /
Left Setback^ `
L/ V
Right Setback
Rear Setback
Additions i Information
1210 main floor
Square Footage
1184 unfinished basement
484 garageco
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2
Cra
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Building Technician
ht- 0/.
Date 1
IyP
3-;)-9G ;
A ;Tkiti
DEPARTMENTAL REVIEW
Approved
Cond.
Approval
Hold
Environmental Health Permit Number
•
W. 1101 College
Room 200
❑
Planning/Zoning
N. 721 Jefferson
Permit Number
❑
Engineers
N. 811 Jefferson
ill
❑
Utilities
N. 811 Jefferson
I
•
Plan Review/Fire Prevention
N. 811 Jefferson
Other (SEPA/Critical Material/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 E— "{-ef
Date
c/ 8
70.00
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ADDRESS E. 15010 Broad Ave.
BROW D AVL
STYLE 2200-Cl1l
LEGAL DESCRIPTION L5 B11 SUMMERFIELD EAST -2nd ADDITION
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APPLICANT TUPPER
JOB # 595
FHA CASE #
POWER WWP
WATER TRENTWOOD
SCALE 1"=20'