1984, 07-09 Permit App: 00001167 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 liens Owe) (first) (m) pspsrfr►Ient Only
Tupper Inc. I � [comm
2 Project Address (not Meiling Address) or Road Name Space Zip
N. 4908 Calvin Road (Job #522) 99216
3 City/Community
Spokane
State
WA
Subdivision/Plat Name
Summerfield East Addn
4 Awes or Petted No.
Portion of 35643-9072
Lot
7
Block
2
* * * DEPARTMENT USE ONLY * *
5 Sic Cods
tons Act. a
Zone
Project No.
Il Le i
8 Dwell
No. of Buildings
Sq. Ft./Acre
Depth
Frontage
7 Set Beck -Front
(L)S-1
(R)S-2
Rear
Census Tract
Module No.
Initials
16 Architect Rrm Name
Street Address
Zip
aty
State
Phone
( )
Contact Person
Phone If different then above
( )
Contractor Firm Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
Zip
99216
sty
Spokane
State
WR
Phone
4509 ) 928-1991
Contact Person
Ken Tupper or Debbie Kracher
License rig.
TUPPEIR179DC
Pncne Ir different than above
( )
8 Owner/Agent (If different than #1 above)
Business Address
9 Zip
City
State
Phone
( )
12 Review Required
N
Plan Cheek (Y/N)
Y
Other (Y/N)
N
SEPA Exempt (YIN)
N
Date
4-25-84
15 Type Work d Bldg
0 Fire
0 MH
❑ Demo
C 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
i 2 f%'/' _ ; i)i
Fast Track/Special Ina
DEPARTMENT APPROVALS
LED_
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
1 nis Ism a rermit
(Indicated approvals required in either "release" or "release with conditions"
space prior to permit issuance.)
Release
Release I
w/cond 1 Hold 2
Environmental Health ❑ Commercial; 0 Residential
W. 1101 College 0 New Construction; 0 Bldg alteration/addition
200 ❑ Additional structure;
gl)
•
i 4 te9
IRoom
i
I
APPLICATION # ' C (C.) (
Conditions/Comments-
onditions/Comments-El
Other:
El
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;
O Other
Conditions/ Comments-
•
Plan Exams
Enginees: 0 Commercial; 0 Residential;0 Flood
/ V
Fire Prev.
Plain;
N. 811 Jefferson 0 drainage 0 new 0 fence;
�^
Conditions/ Comments -
access/approach;
❑ road improvements
onditions/Commenis-
Conditions/Comments-
1 Indata 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 Exams
Fire Prev.
Conditions/ Comments -
0
c
0
co
E
`c
Project Representative Telephone
Agencies Performing Special Inspection:
1
2
3
1 Indata above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for held
a94
Gari' e ./ /o
•
�O/3�/GTf
DrlVC,
z.�
ADDRESS N. 4908 Calvin Road STYLE mac^- G
LEGAL DESCRIPTION Lot 7, Block 2 Summerfield East Addn.
APPLICANT Tupper Inc. POWER W.W.P.
JOB # 522 WATER Trentwood
SCALE 1" = 20'