1983, 07-03 Permit App: 00001140 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 learns part) (first) (m) Department Use Only
Tupper Inc. J J. !Comm
2 Project Address (not Melling Address) or Road Name
`?1. -/ 10,:).-" lX10 , ` 2/
Space Zip
( - OG) 99216
3 Qty/GbnrnunIty
Spokane
Sat.
WA
Subdivision/Plat Name
Summerfield East Addn
4 Maes.or Parcel No.
Portion of 35643-9072
Lot
5_
Block
1
* * * DEPARTMENT USE ONLY * * *
5 Sic Cods
Zone Act. !
Zone
Project No.
8 Dwell
No. of Buildings
Sq. Ft./Acre
Depth
Frontage
7 Set Bed -Fra+t
(L)S-1
(R)S-2
Rear
Cenaua 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
City
Spokane
State
WA
Phone
(509 ) 928-1991
Contact Person
Ken Tupper or Debbie Kracher
License N.
TUPPEIR179DC
Phone If different than above
( )
8 Owner/Apert (if different than 01 above)
-
Business Address
9 Zip
City
State
Phone
( )
12 Review Required
N
Ptan Check (Y/N)
Y
Other (Y/N)
N
SEPA Exempt (Y/N)
N
pate
4-25-84
15 Type Work c Bldg
0 Fire
0 MH
❑ Demo
21C New
❑ Add/ Alter
C Replace
❑ Move
Q1her
b 1 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 Addreaa
Zip
City
State
Phone
( )
Contact Person
Phone It different than above
( )
Additional Information -
/010 ,- — 1u-71 r?"— 32(
4a /it`
Fast Track/Special Insp.
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is nit a Permit
(Indicated approvals required In either "release" or "release with conditions"
space prior to permit issuance.)
Environmental Health
W. 1101 College
Room 200
C Commercial; 0 Residential
O New Construction; ❑ Bldg alteration/addition
O Additional structure;
APPLICATION #t l) q s3
Release
Release
w/cond 1 Hold 2
prifill
i Ile
i- ..41/..... 'El
1
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;
❑ CU, variance, zone change; shoreline; 0 fence;
❑ Other
Conditions/Comments
Engineers: 0 Commercial; 0 Residential; 0 Flood Plain;
N. 811 Jefferson 0 drainage 0 new access/approach; 0 fence;
O road improvements
Conditions / Comments •
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•
■
c
O
11.3
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 Indicate above or attach reasons for held
i±fic) /a c e if
(1'
7,4
Cro•,..tc c
OCK) o I
C if i/ ?0 d
ADDRESS N. 4905 Calvin Road STYLE ..3A00
LEGAL DESCRIPTION Lot 5, Block 1 Summerfield East Addn.
APPLICANT
JOB #
Tupper Inc.
506
SCALE 1" = 20'
POWER W.W.P.
WATER Trentwood
SPO C.T.;;ITY FPTH DISTRICT