1983, 07-03 Permit App: 00001146 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 Nome NW) (first) (m) Use Only
roertrnant
Tupper Inc. . 'Comm
2 Project Address Melling Address) Space
(not or Read Narne Zip
N. 4820 Calvin Road (Job # 524) 99216
3 City/Community
Spokane
Stems
WA
Subdivision/Plat Nerve
Summerfield East Addn
4 Assessor Parcel No.
Portion of 35643-9072
Lot
9
Block
2
* * * DEPARTMENT USE ONLY * * *
5 Sic Code
Zone Act. #
Zone
Project No. q /
(J
6 Dwell#
No. of Buildings
Sq. Ft./Acre
Depth
Frontage
7 Set Beck -Front
(L.)s-1
(R)S-2
Baer
Census Tract
Module No.
Initials
16 Architect Firm Name
I Street Address
Zip
City
State
Phone
( )
Contact Person
Phone If different than above
( )
Contractor Rrm Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
Zip I City
99216 Spokane
State
WA
Phone
(509 ) 928_1991
Contact Person
Ken Tupper or Debbie Kracher
License he
TUPPEIR179DC
Phone If oifrr►ert than above
( )
8 Owner/ Agent (if different than h above)
Business Address
9 Zip
City
State
Phone
( )
12 Review Required
N
Plan Check (Y/N)
Y
Other (Y/ N) SEPA Exempt (YIN)
N II
Date
4-25-84
15 Type Work ?� BldgC
C Fire
MH
❑ Demo
C New
❑ Add/Alter
❑ Replace
El Move
her
bite 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
Plane
(509 )928-1991
Lender
Street Address
Zip
City
State
Plane
( )
Contact Person
Phone if different than above
( )
Additional
lIInformation M c -r
7z7q ds/ii
j/Oq /a4riaji/(_/
/ g-6 %1L(-- (/7/t1G/d I
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is j a Permit
(Indicated approvals required in either 'release" or "release with conditions"
space prior to permit issuance.)
Environmental Health
W. 1101 College
Room 200
O Commercial;
❑ New Construction;
❑ Additional structure;
APPLICATION ##
❑ Residential
O Bldg alteration/addition
Release
Release
w/cond 1
Hold 2
j
Conditions/ Comments
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;
❑ CtJ, variance, zone change; shoreline; 0 fence;
O Other
Conditions/Comments
Engineers: 0 Commercial; 0 Residential;
N.811 Jefferson 0 drainage 0 new access/approach;
O road improvements
Conditions/Comments
❑ Flood Plain;
O fence;
7/3
Utilities:
N. 811 Jefferson
Conditions/Comments'
Other:
Plan Exam
Fire Prev.
Conditions /Comments
Project Representative Telephone
Agencies Performing Special Inspection:
1
3
1 Indicate above or attach conditions relative to final as built approval
2 indicate above or attach reasons for hold
1.17,6,
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ADDRESS N. 4820 Calvin Road
STYLE 2.260
LEGAL DESCRIPTION Lot 9, Block 2 Summerfield East Adan.
POWER W.W.F.
APPLICANT Tupper Inc.
JOB
524 WATER Trentwood
SCALE 1" = 20'
spall+
ITh DISTRICT