1983, 07-03 Permit App: 00001154 Residence*
ti
BUILDING PERMIT APPLICATION WORKSHEET
PEASE 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) Department Use Onty
Tupper Inc. Rms. Comm
I
2 Project Address (not Melling Address) a Road Name Zip
`yI. 1/ g c2-/ ( ` , (. 4 ---z)-5--- 99216
3 City/Community
Spokane
to
WA
bdivision/Plat Name
Summerfield East Addn
4 Aaaaaaor Peroel No.
Portion of 35643-9072
Lot
6
Block
1
* * * DEPARTMENT USE ONLY * * *
5 Sic Coda
Zane Act. *
Zone
Pro(ec1 No.
6 Dwell
No. of Buildings
Sq. Ft./Acre
Depth
Frontage
7 Set Bads -Front
(L)S-1
(R)S-2
Rear
(ensue Tract
Module No.
Initials
16 Architect Firm Name
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone ff different than above
l )
Contractor Firm Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
Zip 1 City
99216 Spokane
Stade
W1,
i
Phone
(5r,9 ' 978-1991
Contact pwson License No
Ken Tupper or Debbie Kracher TUPPEIR179DC _
Phone If deter,nt than above
( )
8 Owner/Agent Cif different than i» above)
Business Address
9 Zip
City
State
Phone
( )
12 Review Required
N
Plan Check (Y/N)
Y
Other (Y/N)SEPA Exempt (Y(N)
N l N
Date
4-25-84
15 Type Work [ Bldg
0 Fire
❑ MH
0 Demo
f New
0 Add/Alter
0 Replace
0 Move
b 1 e ga rage
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 Addrees
Zip
City
State
Phone
l ) ,
Contact Person
Phone if different than above
( 1
Additional Information
c7 %1,9/ Lr(Y 3c)-
/6cD �� a ieUz.r.��
*
Application Type
(Standard unless
otherwise Indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is Lisa a Permit
(indicated approvals required in either "release" or "release with conditions'
space prior to permit issuance.)
Environmental Health
W. 1101 College
Room 200
Condltions / Comments•
❑ Commercial;
❑ New Construction;
E Additional structure;
APPLICATION # ry 3Y -
• Residential
❑ Bldg alteration/addition
4Q
r
Release
w/cond 1
Hold 2
-7---3117
2-347/
Planning/Zoning:
N. 721 Jefferson
❑ Commercial;
❑ Setbacks;
0 Cert. of Exemption;
0 lot w/d; 0 lot size;
❑ Frontage;
0 use/zone;
❑ CU, variance, zone change; shoreline; 0 fence;
❑ Other
Conditions / Comments•
Engineers:
N. 811 Jefferson
Condi tions /Com ments-
❑ Commercial;
❑ drainage
❑ road improvements
❑ Residential;
❑ new access/approach;
❑ Flood Plain;
❑ fence;
7/- sAs`t
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 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 held
ADDRESS
6i'
/2'
hoc l /.= cc o/ ion t' c
f t
9
l. S
1,631 -
C/14 Y /n/ ,Qo s�
N. 4821 Calvin Road
STYLE
LEGAL DESCRIPTION Lot 6, Block 1 Summerfield East Addn.
APPLICANT Tupper Inc.
JOB n 505
SCALE 1'' = 20'
POWER W.W.P.
WATER Trentwood