1984, 04-25 Permit App: 00000635 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 Narne (last) (first) (m) Department Only
Tupper Inc. Ras. Comm
1
2 Protect Address (not Mailing Address) or Road Name Space Zip
}ti.w w `f,' /(,, (vi -v_ u( G,._1 99216
3 City/Community
Spokane
State
WA
Subdivision/Plat Name
Summerfield East Addn
4 Assessor Parcel No.
Portion of 35643-9072
LotBlock
7
I 1
* * * DEPARTMENT USE ONLY * * *
5 Sic Code
Zone Act. 0
Zone
Project No.
I.
6 Dwell 0
No. of Buildings
Sq. Ft./Acre
Depth
Frontage
7 Set Back -Front I (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
( )
Contractor Firm Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
Zip
99216
1 CltyState
Spokane
I WA
Phone
(509 ) 928-1991
s.,;,,-.,�. Fuls-..1,
Ken Tupper or Debbie Kracher
,ic..„i4Y N.
I TUPPEIR179DC
iri,6inC If d`:fer Kitt ti - ii,_ ,,
( )
8 Owner/Agent (if different than 01 above)
Business Address
9 Zip
City
State
Phone
( )
12 Review Required
N
Plan Check (Y/N)
Y
Other (Y/N)
N
SEPA Exempt (Y/N)
N
Date
4-25-84
15 Type Work OX Bldg
0 Fire
❑ MH
0 Demo
Of New
0 Add/Alter
0 Replace
0 Move
ether
b i e 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
Zip
City
State
Phone
( )
Contact Person
Phone If different than above
( )
Additional Information
0
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;
APPLICATION # 7/7 -d v3
Conditions/Comments• Q/j�i/f> 447 •s-�
Release
Release
1
Hold 2
Utilities:
N. 811 Jefferson
l�w/cond
4/
K,i?otc
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
Conditions/Coments:
aid
❑ Commercial; 0 Residential;
❑ drainage 0 new access/approach;
❑ pad impro em:nts
O Flood Plain; I
O fence;
015/
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
•
Utilities:
N. 811 Jefferson
Conditions/Comments.
`Other:
•
Plan Exam
Fire Prev.
Conditions / Comments•
1 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
JOB NO. -.6?)
FHA CASE NO.
_WATER 7 twrzeiC'DD
SCALE
11
= 20'
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