1984, 07-03 Permit App: 00001153 Residence*
BUILDING 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
jest) (first) (m)
IDllprtmentuseOnly
Tupper Inc. Res. ]Comm
2 Profen Aaarwe (not Melling Address) ar ReedKarns Sprite Zip 99216
`7 7 . '/�D 9 tz c,�,off -07) `
/
rr
3 Qty/Cownunity
Spokane
State
WA
Subdivision/Plat Name
Summerfield East Addn
Ae
4 Mew No.
Lot
Block
'
Portion of 35643-9072
,
4
1
* * * DEPARTMENT USE ONLY * * *
5 Sic Code
Zone Act. r
Zone
Project No.
6 Dwell r
No. of Buildings
Sq. Ft./ Acre
Depth
Frontage
7 Set Brick -Front
(L)S-1
(R)S-2
Rear
Census Tract
Module No.
1
Initials
k 16 Architect Firm 'blame 1
N
Street Addrees
Zip
Qty
State
Phone
( )
Contact Person
Phone It different than above
( )
Contractor Firm Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
Zip
99216
Qty
Spokane
State
WA
Phone
(509 ) 928-1991
Opntsket Person
Ken Tupper or Debbie Kracher
License No.
TUPPEIRIZ9DC
Peon it uitterwn than above
( )
8 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)
N
I SEPA Exempt (Y/N) Date
Vete
N 4-25-84
15 Type Work L( Bldg
0 Fire
0 MH
0 Demo
C4 New
0 Add /Alter
0 Replace
0 Move
her
e garage
14 Dosed be Work
Single Family Residence with double garage
10 Applicant Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
11 Zip
99216
Qty
Spokane
State
WA
Phone
(509 )928-1991
Lender
Street Address
Zip
Qty
State
Phone
( )
Contact Person
Phone If different than above
( )
Additional Information.- -_
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*
*
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This ism" a Permit
(Indicated approvals required in either "release" or "release with conditions"
space prior to permit issuance.)
0
Environmental Health ❑ Commercial; ❑ Residential
W. 1101 College E New Construction; 0 Bldg alteration /addition
Room 200 0 AdditionTrture; ,
APPLICATION 1 (IIf(
Release
Release
w/cond 1
Hold 2
Utilities:
N. 811 Jefferson
Conditions/ Comments.
Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage;
N. 721 Jefferson
Conditions/Comments
❑ Setbacks; 0 lot w/d; 0 lot size; 0 use/zone;
❑ CU, variance, zone change; shoreline; 0 fence;
❑ Other
Engineers: 0 Commercial; 0 Residential; 0 Flood Plain; I cam/
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 hold
•
Utilities:
N. 811 Jefferson
Conditions/Comments.
•
Other:
y
D
Plan Exam
Firs Prev.
Conditions/Comments.
Information U
Project Representative Telephone
Agencies Performing Special Inspection:
1
2.
1
1 Indicate above or attach conditions relative to final as built approval
2 indicate above or attach reasons for hold
%73
- 7
13al
f
60"
/� 60"
�C cP 1a c eve (I
8'
..Z otC.il"Cic
1000 q Cl.1
3$:
'
ADDRESS N. 4909 Calvin Road
STYLE
LEGAL DESCRIPTION Lot 4 Block 1 Summerfield East Addn.
APPLICANT Tupper Inc.
JOB # 507
SCALE 1" = 20'
POWER W.W.P.
WATER Trentwood
s3 llt+iti�
!TY 1 E iTH MULCT
a