1985, 10-24 Permit App: 00008331 Residence• (THIS IS NOTA PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
COMPLETE IN INK
(Please return this original and your building plans to the Department of Building and Safety)
.)rlAL7CU HrSCHJ Arun rum LJCr'hlri I IVICfV I NL CLOG
Project Number ���'
Owner's Name LAST FIRST MI
TUPPER INC.
Project Address (Street Name & Number) Zip
N. 4807 Burns Rd. Spokane, Washington 99216
Applicant
TUPPER INC. -
Address
E. 12929 Sprague Ave.
City
Spokane
State
Washington
Zip
99216
Phone
( 509 ) 928-1991
Business Phone
( 509 ) 928-1991
Contractor/Agent
TUPPER INC.
Address
E. 12929 Sprague Ave.
City
Spokane
State
Washington
Zip
99216
Phone
( 509 ) 928-1991
Contact
Ken or Debbie
License Number (Required)
TUPPEIR179DC
Business Phone
( 509) 928-1991
Architect /Engineer
Address
City
State
Zip
Phone
( )
Contac]
Business Phone
( )
Lender
Add ess
City
State
Zip
Phone
( 1
Daacribe V rk
Single Family Residence
Res.
Comm.
Sl twister/ Plat Name/ Short Plat Number
SUMMERFIELD EAST 1ST ADDITION
Assessor Parcel Number
35644-2620
Lot
20
Block Plat Number
6
Pertinent File Numbers
Zone
Comp. Plan 1 Census Tract
I
Number of Dwelling units
1
Number of Buildings
1
Lot Size (Sq. Ft. /Acre)
depth
Frontage
Front Setback
Left Setback
Right Setback
Rear Setback
Acid Mona! Information
1258 main floor
L DEPARTMENT USE
Square Footage
752 basement, unfinished 342 OD
451 garage t• ✓*
15.00
35e. 5O
Building Technician
Date I
1
Group
Type
E
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 is true, correct, legal, and binding.
Owner's Signature
Date _1C' = / 8
Approved
Cond.
Approval
Hold
Environmental Health Permit Number______11..--::/122—.
W. 1101 College
Room 200
I
,
Planning/Zoning
N. 721 Jefferson
Permitt Number
1O
Engineers /Y
N. 811 Jefferson /" A' 6 2
Utilities
N. 811 Jefferson
Plan Review/Fire Prevention
N. 811 Jefferson
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 is true, correct, legal, and binding.
Owner's Signature
Date _1C' = / 8
•
e..
-/
•q,
_?)
3
:7; ' "
1-7...),3 L=4 ; v
. 5
2 1
7ct 7
0 '6,, •
ADDRESS N. 4807 Burns Rd. STYLE 1200
LEGAL DESCRIPZION L20 B6 Summerfield East 1st Addn.
APPLICANT TUPPER INC. POWER WWP
JOB # 529
FHA CASE#
WATER Trentwood
SCALE 1"=20'