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1984, 06-12 Permit App: 00000880 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 Nasse past) (first) (m) Tupper Inc. Department Use Only Res. (Comm 2 Project Address (not Mailing Address) v Road Name Spm Zip N. 4920 Calvin Road (Job #519) 99216 3 City/Corrnrunity Spokane State WA Subdivision/Plat Name Summerfield East Addn 4 Armor Parcel No_ Portion of 35643-9072 Lot 4 Block 2 * * * DEPARTMENT USEONLY * * * 5 Sic Code Zone Act. if Zone Project No. q2 6 Dwell N No. of Buildings -Sq. Ft./Acre Depth Frontage 7 Set Back -Front (L)$-1 (R)S-2 Rear Conus Tract Module No. Initials 16 Architect Firm Name Street Address Zip City State Phone ( ) Contact Person Phone If different than above ( 1 Contractor Firm Nasse Tupper Inc. Street Address East 12929 Sprague Ave Zip 99216 Qty Spokane State WA Phone (509 ) 928-1991 contact Person Ken Tupper or Debbie Kracher LicenNo. License No. Phone al different tha,, abcwe ( ) 8 Owner/Agent (if afferent Nen 81 above) Business Address 9 Zip - Oty State Phone ( ) 12 Review Required N Plan heck (YIN) Y Other (Y/N) N SEPA Exempt (YIN) N Oats 4-25-84 15 Type Work C 0 Bldg Fire 0 MH 0 Demo C New 0 Add/Alter 0 Replace 0 Move I e qa ra ge 14 Describe Work Single Family Residence with double garage 10 Applicant Name Tupper Inc. Street Address East 12929 Sprague Ave 11 Zip 99216 Clty Spokane State WA Phone (509 )928-1991 Lender Street Address Zip City State Phone ( ) Contact Person Phone If different than above ( 1 Additional Information 1202 mn floor 608 basement 484 garage 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.) Environmental Health W. 1101 College Room 200 Conditions/Comments. ❑ Commercial; ❑ New Construction; ❑ Additional structufe; 6C‘7F ❑ Residential ❑ Bldg alteration/addition APPLICATION # Release Release w/cond 1 Hold 2 47.1 kw' .....44. Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage; N. 721 Jefferson 0 Setbacks; 0 lot w/d; ❑ 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 67// Utilities: N. 811 Jefferson Conditions /Comments. Other: Information Plan Exam Fire Prev. Conditions/Comments. 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 'OWE f►l i TY [HEALTH DIS R1 '#' ADDRESS y oar s1' _ RgplacELci f - bo' l�ln er.,f _ loo' itCc ,aI if) -4,":.,d fi Garao'_ l 36.11 �oi CrE.f�, 1rr�✓i- yo' kr..-/- N. < =L N. 4920 Calvin Road LEGAL DESCRIPTION APPLICANT JOB SCALE STYLE %Z3 2200-C1 Lot 4 Block 2 Summerfield East Addn. Tupper Inc. 519 1" = 20' POWER WATER W.W.P. T ren twood