1984, 04-25 Permit App: 00000655 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) Cepertment pee only
. ' Comm
Tupper Inc. R��
I
2 Project Address (not Mailing Address) cr Road Name Space Zip
kJ , A 12. -- 99216
3 City/Community
Spokane
State
WA
Subdivision/PiatName
Summerfield East Addn
4 Assessor Parcel No.
Portion of 35643-9072
Lot
8
Block
1
* * * DEPARTMENT USE ONLY
5 Sic Cade
Zone Act. # '
Zone
Project No. (..0-2---
2--
6 Dwell #
No. of Buildings
-Sq. Ft./Acre
Depth
Frontage
7 Set Bach -Front
I (L 5-1 1(R)5-2
Rear
Cbnsus Tract
Module No.
Initials
16 Architect Firm Name
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone If different than above
( )
Contractor Firm Name
Tupper Inc.
Street
East
Address
12929 Sprague Ave
Zip
99216
City
Spokane
State
WA
Phone
(509 ) 928-1991
C�nir.. Peranr
Ken Tupper or Debbie Kracher
License N..
TUPPEIR179DC
Ptror+e if di:r.:ent :tea^ -,o.r.
` )
8 Owner/Agent (if different than #1 above)
Business
Address
9 Zip
City
State
Phone
( 1
12 Review Required
N
Plan
beck (Y/N)
Y
Other (YIN)
N
SEPA Exempt
(YIN) Dete
N 1 4-25-84
15 Type Work EN
0
Bldg
Fire
^ MH
❑ Demo
New
= Add/Alter
'� Replace
E Move
�c ether
bb I e qa rage
r 14 Describe Work
Single Family Residence
with double garage
10 Applicant Name
Tupper Inc.-
Street
East
Address
12929 Sprague Ave
11 Zip
99216
14
City
Spokane
State
WA
Phone
(509 )928-1991
Lender
Street Address
Zip
City
Stale
Phone
( 1
Contact Person
Phone if different than above
( 1
Additional Information
Fast Track/Special Insp.
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 ❑ Commercial; ❑ Residential
W. 1101 College ❑ New Construction; ❑ Bldg alteration/addition
Room 200 ❑ Additional structure;
APPL ATION #
Y1-/-61/57.
Conditions/Comments-
f307-e4t1--(09-)z-
Release
Release
w1cond 1
Hold 2
4t2
Conditions/Comments.
Planning/Zoning: ❑ Commercial; ❑ Cert. of Exemption; 0 Frontage;
N. 721 Jefferson D Setbacks; 0 lot wld; 0 lot size; 0 use/zone;
❑ CU, variance, zone change; shoreline; ❑ fence;
❑ Other
Conditions/Comments
Engineers: 0 Commercial;
N. 811 Jefferson 0 drainage
Cond'�ins/Co% mentr
❑ Residential;
❑ new access/approach;
❑ Flood Plain;
❑ fence;
"'to
•
Utilities:
N. 811 Jefferson
Conditions/Comments.
•
'Other:
❑
Plan Exam
Fire Prev.
Conditions/Comments.
IInformation ❑
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
2.,
i;
ADDRESS
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LEGAL DESCRIPTION 4.6' ei
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APPLICANT -7-(1t7e /NC --
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