1984, 06-06 Permit App: 00000565 ResidenceJ
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 Nene (last) (first) (m)
Tupper Inc.
Dspertrtie %S Only
Rn- ! Itornm
2 Protect Address (not Mailing Address) or Road Name Space Zip
N. 5013 Calvin Road ;,08idJ;2) 99216
' 3 City/Community
Spokane
State
WA
Subdivision/Plat Name
Summerfield East Addn
4 Assessor Parcel No.
Portion of 35643-9072
Lot
2
Block
3
* * * DEPARTMENT USE ONLY * * *
5 Sic Gads
Zone Acta
Zone
Sf Q.
Protect No.
6 Dweff 1
No. of Buildings
Sq. Ft./Acre
Depth
Frontage
7 Set Balc-Front
(L)S-1
(R)S-2
Rear
Census Tract 1st
Module No.
Initials
16 Architect Finn Name
Street Address
Zip
City
State
Phone
( )
Contac Person
Phone if different Man above
( )
Contractor Firm Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
Zip City
99216 1 Spc-kane
State
4i..
Phone
'509 ) 928"'991
Phone if different tr r sleeve
( )
Contact patio
Ken Tupper or Debbie Kracher
Ucaise No.
TUPPEIR179DC
8 Owner/Agent (if different than 91 above)
Business Address
9 Zip
City
State
Phone
( )
12 Review Required
N
Plan Check (YIN)
Y
Other (YIN)
N
SEPA Exempt (Y/N)
N
Date
5— 84
15 Type Work Bldg
0 Fire
0 MH
0 Demo
C New
0 Add/Alter
0 Replace
0 Move
p4-25-84
�—a2
blear e qa rage
14 Desvtbe 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
( 1
Contact Person
Phone if different than above
( 1
Additional Information
(it4
X C3 -i. Vtif 330
GOD 0 ti 6
484 0 el Az-
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is net 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 structure;
❑ Residential
❑ Bldg alteration/addition
APPLICATION N
Release
Release
w/cond 1
Hold 2
to—co -bi
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;
O CU, variance, zone change; shoreline; 0 fence;
❑ Other
Conditions /Com men is•
Engineers: 0 Commercial; 0 Residential; 0 Flood Plain;
N. 811 Jefferson 0 drainage 0 new access/approach; 0 fence;
O road improvements
Conditions /Comments•
Utilities:
N. 811 Jefferson
Conditions/Comments.
Other:
Plan Exam
Fire Prev.
Conditions / Comments
Project Representative Telephone
Agencies Performing Special Inspection:
1
3
1 Indicate above or attach conditions relative to final as built approval
2 Indkats above or attach reasons for hold
ADDRESS N. 5013 Calvin Road
STYLE
LEGAL DESCRIPTION Lot 2 Block 3 Summerfield East Addn
APPLICANT
JOB #
SCALE
2200-C1
Tupper Inc.
512
1" = 20'
POWER W.W.I'
WATER Trentwood