1984, 06-12 Permit App: 00000982 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 Name (m)
(Inst) (first) Dspertrrient Use Only
Tupper Inc. RsJComm
I
2 Project Address (not Melling Address) or Road Name Space Zip 99216
N. 4912 Calvin Road (Job #521)
3 City/Community
Spokane
Stage
WA
Subdivision/Plat Name
Summerfield East Addn
4 Armor Parcel No.
Portion of 35643-9072
Lot
6
Block
2
'
* * * DEPARTMENT USE ONLY * * *
5 Sic Code
Zone Act. i
Zone
Project No.
6 Dw-i
No. of Buildings
Sq. Ft./Acre
Depth
Frontage
7 Set Bads -Front
(L)S-1
(R)S-2
Rear
Census Tract
Module No.
Initials
16 Architect Firm Name
Street Address
Zip
City
State
r Phone
( )
Conte Person
Phone If different tarn above
( )
Contractor Firm Name
Tupper Inc.
Street Address
East 12929 S•ra.ue Ave
Zip
99216
City
Spokane
State
W%
Phone
(S09 ) 928-1991
Content Person
Ken Tupper or Debbie Kracher
License ) .
TUPPEIR179DC
—____
Phnnt, ei aifterent than above:
( )
8 Owner/Agent Cif different than it above)
Business Address
9 Zip •
City
State
Phone
( )
12 Review Required
N
Plan
Check (Y/N)
Y
Other
N
Exempt(YIN) (Y/N)
1 SEPA N
Date
4-25-84
15 Type Work 1
0
Bldg
Fire
❑ MH
0 Demo
12F New
0 Add/Alter
❑ Replace
❑ Move
b 1 e qa 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 Address
Zip
City
State
Phone
( )
Contact Person
Phone 0 different than above
( )
Additional Information
996 mn floor
944 basement
484 -double garage
100 uncovered deck
Fast Track/Special Insp.
1
DEPARTMENT APPROVALS
•
0
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
1.
1 nls is !ma rermit
(Indicated approvals required in either "release" or "release with conditions"
space prior 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
• `.; CCtf
y'.
APPLICATION #l>4 (//)
� �
Conditions/Comments-
•
Other:
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;
•
Plan Exam
0 CU, variance, zone change; shoreline; 0 fence;
❑ Other
Conditions / Comments•
Firs Prsv.
D
Engineers: 0 Commercial; Residential; 0 Flood Plain;
N. 811 Jefferson 0 drainage new access/approach; 0 fence;
I (.'
�f L
K
❑ 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
Firs Prsv.
Conditions/Comments*
I 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
n '7
1 l
'7 7i
_ i
SPIE COUNTY HEALTH DISTRICT
&,4699
s„7,00,r/
// /792
ADDRESS
7). to
SG'
1efl i -C. 11111' + —
30.;}
3G. 1
CL/GO
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.TD
•
po.oc
f 7
N. 4912 Calvin Road
CAL V/A) ,e0.41,()
LEGAL DESCRIPTION
APPLICANT
JOB =
SCALE
STYLE
2200-D
Lot 6, Block 2 Summerfield East Addn
Tupper Inc.
521
1" = 20'
POWER
W.W.P.
WATER Trentwood