1984, 06-06 Permit App: 00000571 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 Name (last) (first) (m)
Us
Department f91 Y
Tupper Inc.
►ae. I Comm
2 Pra)ect Address (not Muting Address) a Road Name SPS Zip
N. 5021 CALVIN ROAD (JOB #513) 99216
3 qty/Community
Spokane
State
WA
Subdlvlsion/Plat Name
Summerfield East Addn
4 Ase.aeor Parcel No.
Portion of 35643-9072
Lot
1
Block
3
* * it DEPARTMENT USE ONLY * * it
5 Sic Code
Zane Act. fl
Zone �2
Project No. /►
1
6 Dwell ft
No. of Buildings
Sq. Ft./Acre
Depth
Frontage
7 Set Beck -Front
(L)S-1
(R)S-2
Rear
Census Tract
Module No.
Initials
' 16 ArdMtect Firm Name
Street Address
Zip
qty
State
Phone
( )
Contact Person
Phone If different than above
( )
Contractor Firm Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
Zip
99216
qty
Spokane
State
4'.'.
Phone
(5^9 ) 928-1991
c Intact Person
Ken Tupper or -Debbie Kracher
License No.
TUPPEIR179DC
Phone if different than above
_ ( )
8 Oester /Agent (If different than #1 above)
Business Address
9 Zip -
qty
State
Phone
( )
12 Review Required
N
Plan
Check (Y/N)
Y
Other (Y/N)
N
SEPA Exempt (YIN)
N
Date
4-25-84
15 Type Work
0
Bldg
Fire
❑ MH
0 Demo
New
0 Add/Alter
❑ Replace
0 Move
b 1pe qa rage
14 Describe Work
Single Family Residence
with double garage
10 Applicant Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
11 Zip
99216
qty
Spokane
State
WA
Phone
(509 )928-1991
Lender
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone if different than above
( )
Additional Information
%202.41 ttr 321
Z42 Ce kS
44404Ike-
Fast Track/Special Ins
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
k
DEPARTMENT APPROVALS
This issa 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;
O Residential
O Bldg alteration/addition
APPLICATION I
Release
Release
w/cond 1
Hold 2
(4° — ieti
,..,,-
Planning/Zoning: ❑ Commercial; 0 Cert. of Exemption; 0 Frontage;
N. 721 Jefferson 0 Setbacks; 0 lot w/d; 0 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; I
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•
I Information ❑l
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
ADDRESS N. 5021 Calvin
STYLE 3200
LEGAL ADDRESS Lot 1 Block 3 Summerfield East Addn.
APPLICANT Tupper Inc. POWER W.W.P.
JOB NO
SCALE
SPr4KANE
513
1" = 20'
77
a
WATER.Trentwood
. 7
/Al