1984, 06-12 Permit App: 00000986 Residences L
f
*
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 Name (lest) (first) (m) DspertrnentUmOnly
Tupper Inc. Roe. IComm
1
2 Praiset Address prat Mailing Address) or Road Name Space Zip
N. 5010 Calvin Road (Job #517) 99216
3 City/Community
Spokane
State
WA
Subdivision/Plat Name
Summerfield East Addn
4 Assessor Parcel No.
Portion of 35643-9072
Lot
2
Block
2
* * * DEPARTMENT USE ONLY * * *
5 Sic Cods
Zone Act. 1
Zone
Project No.6( (t✓rth.,
6 Dwell1
No. of Buildings
Sq. Ft./Acre
Depth(e
Frontage
7 Set Back -Front
(L)S-1
(R)S-2
Rear
Oeneue Tract
Module No.
Initials
16 Architect Firm Name
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone If different than above
( )
Contractor Firm Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
Zip 'CRY
99216 Spokane
State
WA
Phone
(509 ) 928-1991
Contact Per win
Ken Tupper or Debbie Kracher
License No.
TUPPEIR179DC
4none if different than above
( )
8 Owner/Agent (lf different Yin 11 above)
Business Address
9 Zip
City
State
Phone
( )
12 Review Required
N
Plan Check (YIN)
Y
Other (Y/N) I SEPA Exempt (YIN)
N N
Date
4-25-84
15 Type Work [ Bldg
0 Fire
0 MH
0 Demo
New
0 Add/ Alter
0 Replace
❑ Move
tin
bis 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 I n f omit i on
996 mn floor
944 basement
484 -garage
100 uncovered deck
1
DEPARTMENT APPROVALS
•
•
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
1 rim is m a rermit
(Indicated approvals required In either "release" or "release with conditions"
space prior to permit issuance.)
Utllitles:
N_ 811 Jefferson
Release
Release
w/cond 1
Hold 2
❑
Environmental Health ❑ Commercial; 0 Residential
W. 1101 College 0 New Construction; 0 Bldg alteration/addition
Room 200 0 Additional structure.
�-�� ,
`, t
I
APPLICATION • U ‘��
Conditions/ Comments-
•
Other:
❑
Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage;
N_ 721 Jefferson 0 Setbacks; 0 lot wld; 0 lot size; 0 use/zone;
•
Plan Exam
❑ CU, variance, zone change; shoreline; 0 fence;
❑ Other
Conditions/ Comments*
Firs Prev.
Engineers: 0 Commercial; tg Res.dential;f.❑ Flood Plain;
141_811 Jefferson 0 drainage A new access/approach; 0 fence;
I scic
elA
❑ road improvements
Conditions /Comments
c
0
El E
`o
`c
1 indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for held
•
Utllitles:
N_ 811 Jefferson
Conditions/Comments.
•
Other:
•
Plan Exam
Firs Prev.
Conditions/Comments.
c
0
El 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 held
,SPOKANE GOUTY HEALTH DISTRICT
W�1
ADDRESS
/nov
?8'
'
COI =°c"it '
•.''. '
L.: rive_
N. 5010 Calvin Road
LEGAL DESCRIPTION
1/^J KM1,)
STYLE
0
L. '
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/K
'494
442°-
22O0 -D
Lot 2, Block 2 Summerfield East Addn.
APPLICANT Tupper Inc.
JOB # 517
SCALE l'' ~ 20'
POWER W.W.P.
WATER Trentwood
70