1983, 07-03 Permit App: 00001144 Residence*
1
BUILDING 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 Nano (last) (first) (m)
Department Use Only
Tupper Inc.
Res. Comm
2 Project Addr s (not fulling Address) or Road Name SPace Zip
n. y �� ( ;t. I, (� f-. ,)—..2 /.) 99216
3 City/Community
Spokane
State
WA
Subdivision/Plat Name
Summerfield East Addn
4 Assessor Pared No.
Portion of 35643-9072
Lot
11
Black
2
* * * DEPARTMENT USE ONLY * * *
5 Sic Code
tons Act. 1
Zone
Project No.
6 Dwelt 1
No. of Buildings
Sq. Ft./Acre
Depth
Frontage
7 Set Beek -Front
(L)S-1
(R)S-2
Rear
Census Tract
Module No.
Initials
' 16 Architect Firm Name
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone If different than above
( )
Gbrrtractor Firm Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
Zip
99216
sty
Spokane
State
WA
I Phone
`509 ' 92P -1q91
Goad Person
Ken Tupper or Debbie Kracher
Liaenae No.
j TUPPEIR179DC
Phone!, drfke'e. t than ab^.e
1 ( )
8 Owner/ Agent (if different than 11 above)
Business
Address
9 Zip
City
State
Phone
( )
12 Review Required
N
Plan
check (Y/N)
Y
Other (YIN)
N
SEPA Exempt (YIN)
N
Date
4-25-84
15 Type Work ❑X
El
Bldg
Fire
❑ MH
0 Demo
C New
0 Add/Atter
❑ Replace
❑ Move
Qtheer
b 1 garage
14 Describe Work
Single Family Residence
with double garage
10 Applicant Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
11 Zip
99216
City
Spokane
State
WA
Phone
(509 )928-1991
Lender
Street Address
Zlp
City
State Phone
( 1
Contact Person Phone it different than above
( )
4..--..„4.
Additional Information Al6 /Y2
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rye eS/
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*
Fast Track/SpeclalInsp.
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is ngt a Permit
(Indicated approvals required in either 'release" or "release with conditions"
space prior to perrr it issuance.)
Environmental Health
W. 1101 College
Room 200
Conditions /Comments
❑ Commercial;
O New Construction;
O Additional structure; G `/
APPLICATION # 7 —
O Residential
O Bldg alteration/addition
X
Release
Release
w/cond 1
Hold 2
Utilities:
N. 811 Jefferson
Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage;
N. 721 Jefferson 0 Setbacks; 0 lot wld; 0 lot size; 0 use/zone;
❑ CU, variance, zone change; shoreline; 0 fence;
❑ Other
Conditions/Comments.
Engineers: 0 Commercial; 0 Residential; 0 Flood Plain;
N. 811 Jefferson 0 drainage 0 new access/approach; 0 fence;
O road improvements
Conditions/Comments.
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for held
•
Utilities:
N. 811 Jefferson
Conditions/Comments.
•
Other:
•
Plan Exam
Fire Priv_
Conditions/Comments.
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 held
4
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ADDRESS N. 4812 Calvin Rd.
.25-3
STYLE 00–D
LEGAL DESCRIPTION Lot 11 Block 2 Summerfield East Addn.
APPLICANT
JOE #
SCALE
Tupper Inc.
526
1" = 20'
Sorel r :777 ,
r thaEillL T .7,
U.L.,.'tMtt ;ATLT
POWER W.W.P.
WATER Trentwood