1984, 07-03 Permit App: 00001151 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 Orner'a Narks
(test) (first) (rn) Deportment Um Only
Tupper Inc. Rte. comm
I
2 Project Address (not Melling Address) or Reed Name Space Zip
_4 -`/1/7 ('..LiA. ; j- ��`� , ,-).-07) 99216
3 Qty/Cormwnity j
Spokane
State
WA
Subdivision/Plat Name
Summerfield East Addn
4 Assessor Parcel No.
Portion of 35643-9072
Lot
2
Block
1
I * * * DEPARTMENT USE ONLY * * *
5 Sic Cods
tone Act. t
Zone Protect No.
6 Drell I
No. of Buildings
-Sq. Ft./Acre
Depth
Frontage
7 Set Beck -Front
(L)S-1
'(R)S-2
r Rear
Census Tract
Module No.
Initials
16 Architect Firm Name
1 Street Address
Zip
City
State
Phone
( )
Contact Person
Phone If different than above
( )
Contractor Fi►m Name
Tupper Inc.
Street
East
Address
12929 Sprague Ave
25p
99216
Qty I
Spokane
State
WA
Phone
'509 ' X28-1991
Contact Pham
Ken Tupper or Debbie Kracher
Lowtae No.
TUPPEIR179DC
Phone if oilier n "nen &novo
( )
8 Owner/Agent (if different than •1 above)
Business
Address
9 Zip
Qty
State
Phone
( )
12 Review Required
N
Plan
Check (Y/N)
Y
Other (YIN)mpt
N
I SEPA
Exempt
(Y/N)
Date
4-25-84
15 Type Work DrX
-:
Bldg
Fire
E MP -1
D Demo
f New
❑ Add/Alter
Replace
Move
glher
b 1 e Qct rage
14 Describe Work
Single Family Residence
with double garage
10 Applicant Name
Tupper Inc.
Street
East
Address
12929 Sprague Ave
11 Zip
99216
Qty
Spokane
State
WA
Krone
(509 )928-1991
Lender
Street Address
Zip
City
State
Phone
1 1
Contact Parson
Phone If different than above
1 1
Additional Information
aLO 4.1/ Ca4i ver. )
Fast Track/Special Insp.
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is= a Permit
(Indicated approvals required in either "release" or "release with conditions"
space prior to permit issuance.)
El
Environmental Health
W. 1101 College
Room 200
❑ Commercial;
❑ New Construction;
❑ Additional structure;
APPLICATION N
❑ Residential
❑ Bldg alteration /addition
Release
Release
w/cond 1
Hold 2
r011
Conditions /Comments•
Planning/Zoning: 0 Commercial;
N. 721 Jefferson 0 Setbacks;
Conditions/Comments-
❑ Cert. of Exemption;
0 lot w/d; 0 lot size;
❑ Frontage;
0 use/zone;
❑ CU, variance, zone change; shoreline; 0 fence;
❑ Other
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 hold
•
Utilities:
N. 811 Jefferson
Conditions/Comments•
❑
Other:
❑
Plan Exam
Flre Prev.
Conditions/Comments-
■
c
0
TO
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 hold
ADDRESS
477
T Bias
Gr'
Lo 7I
/i
0'
//•'
/coo cf>l far i
3 8'
r-
/V/;2 /!:,a
' 9'
4POKANE:�
N. 4917 Calvin Road STYLE
LEGAL DESCRIPTION Lot 2, Block 1 Summerfield East Addn.
APPLICANT Tupper Inc. POWER W.W.P.
JOB r 509 WATER Trentwood
SCALE 1" = 20'