1986, 03-31 Permit App: 00011048 Residence(THIS IS NOTA PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
COMPLETE IN INK L
(Please return this original and your building plans to the Department of Building and Safety) 43 r
SHADED AREAS ARE FOR DEPARTMENTAL USE
Project Number i tell./8
Owner's Name LAST FIRST MI
TUPPER, INC.
Project Address (Street Name & Number) Zip
E. 15022 Broad Ave. Spokane, Washington 99216
Applicant
TUPPER INC.-
Address
E. 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
Ucense Number (Required)
TUPPEIR179DC
Business Phone
(509 1928-1991
Architect l Engineer
Address
City
State
Zip
1
phone
1
Contact
Business Phone
( 1
Lender
Address
City
State j Zip
1
Phone
( 1
y
r> - - • - - - - -
SFR '.
• Ree.-
.
bd(visions ptffi Name/Short Plat Number,
SUMMERF I ELD EAST 2ND ADDITION 3�‘�yC7S �i � �,�%I�i/i/'�'��'
Assessor Paaet Number
Lot
3
Block
11
Plat Number
r"tbs tlrent Fite Number*
Zone
Comp. Plan
Census Tract
lumber of ()moiling Units
1
Number of Buildings
1
Lot Size (SQ. Ft./Acre)
12,222
Depth
Frontage
52.35
front Setback 1 Left Setback
Right Setbac
Rear Setback
Additional IMbrniation
1210 Main floor
1 DEPARTMENT USE
Square Footage
1184 unfinished basement
484 garage
'Building Technician
Date
Group
3
Type
v NI
E
❑
DEPARTMENTAL REVIEW
Approved
Cond.
Approval
Hold
Environmental Health
W. 1101 College
Room 200
Permit Number
Planning/Zoning
N. 721 Jefferson
Engineers
N. 811 Jefferson
Permit Number
Utilities
N. 811 Jefferson
Plan Review/Fire Prevention
N. 811 Jefferson
Other (SEPA/Critical Material/etc.)
Fast Track/Special Inspection Information
Project Representative
Phone
Address
I cert 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 c-1 6- C'
ADDRESS E. 15022 Broad Ave.
STYLE 2200-C111
LEGAL DESCRIPTION L3 B11 SUMMERFIELD EAST 2nd ADDITION
APPLICANT TUPPER
JOB # 597
FHA CASE #
POWER WWP
WATER TREHTW00D
SCALE 1"=20'