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1984, 06-12 Permit App: 00001002 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 Nems peat) (first) (m) Department Use Only Tupper Inc. ►�. 1Comm 2 Project Address (not Meiling Address) a Road Name Space Zip N. 4921 Calvin Road (Job #510) 99216 City/Community Spokane State WA Subdivision/Plat Name Summerfield East Addn 4 Assessor Parcel No. Portion of 35643-9072 Lot 1 Block 1 * * * DEPARTMENT USE ONLY * * * 5 Sic Code Zone Act. N Zone Protect No. 6 Dwell if No. of Buildings Sq. Ft./Acre Depth Frontage 7 Set 8edk-Front (L)S-1 (R)S-2 Rear Census Tract Module No. Initials 16 Architect Firm Name Street Address Zip City State Phone ( ) Contact Person Phone if different than above ( 1 Contractor Firm Name Tupper Inc. Street Address East 12929 Sprague Ave Zip Oty State 99216 Spokane W4 Phone (F)C1) 92F-1991 Contact Porv'n Ken Tupper or Debbie Kracher Lia( mss i4o 1 TUPPEIR179DC Pnone it c,fte-ent Ulan r i ove ( ) a Owner/Agent (if different than #1 above) Business Address 9 Zip - City State Phone ( ) 12 Review Required N Plan Check (YIN) Y Other (Y/N) N SEPA Exempt (YIN) N Date 4-25-84 15 Type Work t Bldg 0 FWe 0 MH 0 Demo I New 0 Add/Alter C Replace 0 Move b IQe 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 1202 mn floor 242 basement 484 double garage ast Track/Special Insp. 1 DEPARTMENT APPROVALS TL • _• C G Application Type (Standard unless otherwise indicated) Fast Track Early Start 1 nis Is 1_12I a rermit (Indicated approvals required in either "release" or "release with conditions" space prior to permit issuance.) Release Release w/cond 1 Hold 2 Cl*i Environmental Health CI Commercial; 0 Residential, W. 1101 College 0 New Construction; 0 Bldg alteration/addition Room 200 0 Additional structure; `_s1 ( G APPLICATION # // l'&°(p �7 Conditions/Comments. C Other: © Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage; N. 721 Jefferson ❑ Setbacks; 0 lot wld; 0 lot size; 0 use/zone; Plan Exam 0 CU, variance, zone change; shoreline; 0 fence; ❑ Other Condi tions / Comments Conditions / Comments• D Engineers: 0 Commercial; V Residential; 0 Flood Plain; N. 811 Jefferson 0 drainage new 0 fence; C' I Cl/ 1 1 Information ❑ Project Representative Telephone access/approach; O road improvements Cond l t ions /Comments • 2 1 Indicate above or attach condition relative to final as built approval 2 Indicate above or attach reasons for held ❑ Utilities: N. 811 Jefferson Conditions/Comments. C Other: • Plan Exam Fire Pre,. Conditions / Comments• 1 Information ❑ Project Representative Telephone Agencies Performing Special Inspection 1 2 3 1 Indicate above or attach condition relative to final as built approval 2 Indicate above or attach reasons for held a7J 56' k ,4a a 1006 oGf 3 #J. SP&KAf3� :i � i' rb LTid ENSTRICT 7/a i Cert c/C'%G * Ori -c • 2,4LV/N koh't ADDRESS N. 4921 Calvin Road STYLE 3200 LEGAL DESCRIPTION Lot 1 Block 1 Summerfield East Addn. 6/v/v/ APPLICANT Tupper Inc. POWER W.W.P. JOB # 510 WATER Trentwood SCALE 1" = 20' "631,19 - 3/, t'r 87-5( 1 /`''.�jo • Tvsyte i-- —1 j 1 DEPARTMENTAL REVIEW I certify that I have examined this application and state that the Information contained in It and submitted by me or my agent to compile said application is true and correct. Signature Date Approved Cond. Approval Hold Environmental Health Application # � -4(20_1______ � 4Uj gl l / fij' W. 1101 College Room 200 Planning/Zoning N. 721 Jefferson Engineers N. 811 Jefferson Utilities N. 811 Jefferson 111 Plan Review/Fire Prevention Jefferson N. 811 Other (SEPA/Critical Material/etc.) Fast Track/Special Inspection Information Project Representative Phone Address I certify that I have examined this application and state that the Information contained in It and submitted by me or my agent to compile said application is true and correct. Signature Date