1984, 04-25 Permit App: 00000645 ResidenceBUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
(Please return this original and your building plans to the Department of Building and Safety)
1 Owner's Name (last) (first) (m)
Tupper Inc.
Department Only
R35. 1 comm
2 Project Address (not Meiling Address) or Road Name Space
Spm Zip 99216
3 City/Community
Spokane
State
WA
Subdivision/Plat Name
Summerfield East Addn 12:4:._
4 Assessor Parcel No.
Portion of 35643-9072
Lot
10
I Block
1
* * * DEPARTMENT USE ONLY
5 Sic Code
Zone Act. #
Zone
Project No.
t.7
6 Dwell#
No. of Buildings
Sq. Ft./Acre
Depth
Frontage
7 Set Back -Front (L)S-1
(R)S-2
I Rear
Census Tract
I Module No.
Initials
16 Architect Firm Name
Street Address
Zip
City
State
Phone
( )
Contact meson
Phone if different than above
( )
Contractor Firm Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
Zip
9921
I City
Spokane
State
WA
Phone
(509 ) 928-1991 _
tfxitt r. Pa, son
Ken Tupper or uebbie Kracher
License No
TUPPEIR179DC
. P.-tr,;.i. if tiiferpr t th.fn above
i ( )
8 Owner/Agent (if different than #1 above)
Business
Address
9 Zip
City
State
Phone
( )
12 Review Required
N
Plan
Check (Y/N)
Y
Other (Y/N)
N
SEPA Exempt
(YIN)
N
Date
4-25-84
15 Type Work
0
Bldg
Fire
12MH
0 Demo
New
0 Add/Alter
_^_ Replace
CT, Move
Qther
b 1 e garage
14 Describe Work
Single Family Residence
with double garage
10 Applicant Name
Tupper Inc.
Street
East
Address
12929 Sprague Ave
11 Zip
99216
City
Spokane
State
WA
Phone
(509 '928-1991
Lender
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone if different than above
1 1
Additional Information
❑
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is nota Permit
(Indicated approvals required in either "release" or "release with conditions"
space prior to permit issuance.)
Environmental Health
W. 1101 College
Room 200
Conditions/Comments.
❑ Commercial;
❑ New Construction;
❑ Additional Q structure;
APPLICATION # - w3_5
C Residential
C Bldg alteration/addition
4
Release
Release
w/cond 1
Hold 2
4/x
KCecU..
Conditions /Comments
j-7.6,4„.9 er/
Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage;
N. 721 Jefferson 0 Setbacks; 0 lot w/d; 0 lot size; 0 use/zone;
❑ CU, variance, zone change; shoreline; 0 fence;
❑ Other
Conditions/Comments.
Engineers:
N. 811 Jefferson
❑ Commercial; C Residential;
❑ drainage L: new access/approach;
❑ rrgad improvements
Cor�ditio/Comments. �'Li'`�t />>> �n�2f)
❑ Flood Plain;
❑ fence;
•
Utilities:
N. 811 Jefferson
Conditions /Comments
MI
'Other:
❑
Plan Exam
Fire Prev.
Conditions/Comments.
J Information ❑
Project Representative Telephone
Agencies Performing Special Inspection:
1
2
3
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
1
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