1984, 06-12 Permit App: 00000981 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 None (first) (m) Deportment Use Only
(lest)
Tupper Inc. me.'Comm
I
2 Proiert Address (not Mailing Address) or Road Name Space Zip
N. 4904 Calvin Road (Job # 523) 99216
3 City/Community
Spokane
State
WA
Subdivision/Plat Name
Summerfield East Addn
4 Assessor Parcel No.
Portion of 35643-9072
Lot
8
Block
2
* * * DEPART1rtENTUSE ONLY -or* *
5 Sic Cods
Zan Act. t
Zane
Project No. 4 v( /
8 Dwell /
No. of Buildings
Sq. Ft. /Acre
Depth
Frontage
7 Set Back -Front
(L)S-1
(R)S-2
Rear
Census Tract
Module No.
Initials
16 Architect Firm Name
Street Address
Zip
City
State
Phone
( )
Contac Person
Phone if different than above
( )
Contractor Firm Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
Zip I CityState
99216 Spokane I Wn
Phone
(Sec ' 428-1991
Contac, Person TasinNi No.
Ken Tupper or Debbie KracherTUPPEIR179DC
Phone od•fterant ttka auove
( )
S Owner/Agent (if different than 91 above)
Business Address
9 Zip •
City
State
Phone
( )
12 Review Required
N
Plan Check (Y/N)
Y
Other (Y/N) I SEPA Exempt (YIN)
N N
Date
4-25-84t
15 Type Work c? Bldg
0 Fire
❑ MH
0 Demo
New
0 Add/Alter
0 Replace
❑ Move
b Ipe 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
( 1
Contact Person
Phone 0 different than above
( )
Additional Information
996 mn floor 4 304.
944 basement
484_double garage
100 uncovered deck
AI.1Z2g
a
co
co0.
a
1
DEPARTMENT APPROVALS
❑
•
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
1nisisnQtarermlt
(Indicated approvals required In either 'release" or "release with conditions"
space poor to permit issuance.)
Utilities:
N. 811 Jefferson
Release
Release
w/cond 1
Hold 2
❑
Environmental Health ❑ Commercial; ❑ Residential
W. 1101 College 0 New Construction; 0 Bldg alteration/addition
Room 200 0 Additional structure;
',�'
APPLICATION # g qI d7Od
Conditions /Comments-
•
Other:
•
Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage;
N. 721 Jefferson 0 Setbacks; 0 lot wld; 0 lot size; 0 use/zone; 4-
Plan Exam
❑ CU, variance, zone change; shoreline; 0 fence;
❑ Other
Conditions/ Comments•
Fire Prev.
2
Engineers: 0 Commercial; Residential; 0 Flood Plain;
N. 811 Jefferson 0 drainage new access/approach; 0 fence;
I
` ('
❑ road improvements
Conditions /Comments
c
O
E
`o
c
1 Indicate above or attach conditions relative to final as built approval
2 <ndicato above or attach reasons for hold
•
Utilities:
N. 811 Jefferson
Conditions/Comments-
•
Other:
Plan Exam
Fire Prev.
Conditions/Comments-2
c
O
E
`o
c
Project Representative Telephone
Agencies Performing Special Inspection:
1
2
3
1 Indicate above or attach conditions relative to final as built approval
2 <ndicato above or attach reasons for hold
SFORANE COU iTY HEAL N DISTRICT
4/-4/
411.
•
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Goraye
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Lolue,
gar
C
Cr.
ADDRESS N. 4904 Calvin Road
//it) 12/',L -b
STYLE 2.200-D
LEGAL DESCRIPTION Lot 8, Block 2 Summerfield East Addn.
APPLICANT Tupper Inc. POWER W.W.P.
JOB # 523 WATER Trentwood
SCALE
1" = 20'