1984, 06-12 Permit App: 00000990 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 tare part) (first) (m)
O.partrnsnt Only
Tupper Inc.
Rte. ]Comm
2 Project Address (riot Mailing Address) a Road Name Space Zip
N. 5018 Calvin Road (Job #516) 99216
3 city/Community
Spokane
State
WA
Subdivision/ Plat Name
Summerfield East Addn
4 Assaasor Parol No.
Portion of 35643-9072
Lot
1
Block
2
* * * DEPARTMENT USE ONLY * * *
5 Sic Code
Zone Act. 0
Zone
Project No
qq
6 Dwell 0
No. of Buildings
Sq. Ft. /Acre
Depth
Frontage
7 Set Back -Front
(L)S-1
(R)S-2
Rear
Census Tract
Module No.
Initials
16 Architect Firm Name
Street Address
Zip
City
State
Phone
( )
Coated Person
Phone If different than above
( )
Contractor Firm Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
Zip I city '
99216 S; Aane
State Phone
WP (509 ) 923-19 )
Contact Parson! _-._---- __--- ----..._. -'---1:17e-ns-e"1-447.--^
Ken Tupper or Debbie Kracher
- -Vone
TUPPEIR179DC
if different than above r
1 ( )
Owner/Agent different Yen 01
Business
Address
8 (if above)
9 Zip -
City
State
Phone
( )
12 Review Required
N
Plan Check (YIN)
Y
Other (YIN) SEPA Exempt
N ,
(YIN)
N
Date
4-25-84
15 Type Work Bldg
0 Fire
0 MHN
0 Deo
New
0 Add/Alter
0 Replaceher
❑ Move
b t e ga ragDemo e
14 Describe Work
Single Family Residence with double garage
10 Applicant Name
Tupper Inc.
Street
East
Address
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
9y� �;, �� _/ cd.e) A /'
/iy �� ,,
Fast Track/Special Ins
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is j a Permit
(Indicated approvals required In either 'release" or 'release with conditions'
space prior to permit issuance.)
Environmental Health
W. 1101 College
Room 200
❑ Commercial;
❑ New Construction;
❑ Additional structure;
APPLICATION 1 i(
❑ Residential
O Bldg alteration/addition
Release
Release
w/cond 1
Hold 2
MISillivii
y:►!'
Conditions/Comments-
El
onditions/Comments
Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage;
N. 721 Jefferson 0 Setbacks; 0 lot wld; 0 lot size; 0 use/zone;
❑ CU, variance, zone change; shoreline; 0 fence;
❑ Other
Conditions/ Comments.
Engineers: 0 Commercial; Residential; 0 Flood Plain; I 01 4\ ,
N.811 Jefferson 0 drainage jJ new access/approach; 0 fence; 0 Z'
O road improvements
Conditions/Comments
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for held
•
Utilities:
N. 811 Jefferson
Conditions/Comments'
•
Other:
•
Plan Exam
Fire Prev.
Conditions/Comments-
Information ❑,
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
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iPditANE CONTI( HEALTH DISTRICT
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ADDRESS N. 5018 Calvin Road
STYLE 2200-B
LEGAL DESCRIPTION Lot 1 Block 2 Summerfield East Addn,
APPLICANT Tupper Inc.
JOB NC 516
SCALE 1" = 20'
POWER N.W.P.
WATER Trentwood