1986, 03-31 Permit App: 00011047 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)
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Project Number / /CJ747�
Owner's Name LAST FIRST MI
Tupper, Inc.
Project Address (Street Name & Number) Zip
E. 1 016 Broad Ave. S•okane Wa. 99216
Applicant
Tupper, Inc.
Address
_. 12929 Sprague
City
_pokane
State
Wa
Zip
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
( )
Contact
Business Phone
1 )
Lender
Address
City
State
Zip
Phone
( 1
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LotPlat•
4
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Zone J
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Census Tract
Number of Dwelling kinds
- 1
Number of Buildings
1
Lot Size (Sq. FVt./Acre)
12,582
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,1258 main floor
ENT USE
Footage
;'752 basement unfinished
'451 garage
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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
Plan Review/Fire Prevention
N. 811 Jefferson
Other (SEPA/Crlticat 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 \
Date
S'
/.)S.L
ADDRESS E. 15016 Broad Ave.
STYLE 1200
LEGAL DESCRIPTION L4 B11 SUMMERFIELD EAST 2nd ADDITION
APPLICANT TUPPER
JOB #
596
FHA CASE #
PERMIT #
POWER WWP
WATER TRENTWOOD
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Address: E. 15016 Broad Avenue Style:
3200
/41-112771
Legal Description: L4 all Summerfield East 2nd Addition
Applicant: Tupper Power: WWP
Job #: 596 Water: Trentwood
FHA Case #: Scale: 1"=20'
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