1985, 07-18 Permit App: 00006445 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)
Jr'IAUCU Arimmo AMC r'Urt UCYAN 1 IVI CIN 1 AL UJC
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Project Number ":14c
/ l 1
Owner's Name LAST FIRST MI
Tupper Inc.
Project Address (Street Name & Number) Zip
N. 4815 Burns Rd. Spokane, Washington 99216
Applicant
Tupper Inc
Address
E. 12929 Sprague
City
Spokane
State
Washington
Zip
99216
Phone
(509 ) 928-1991
Business Phone
( )
Contractor /Agent
Tupper Inc
Address
E. 12929 Sprague
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 I Zip
I
Phone
( )
Contact..
Business Phone
( )
Lender
Address
City
State
Zip
Phone
(
Describe Work
Single Family Residence with Double Garage
Fes.
Comm.
Subdivision/Plat Name/Short Plat Number
Summerfield East First Addition
Assessor Parcel Number
Portion of #35643-9076
toot
19
i3iock
6
Piet Number
Pertinent File Numbers
Zone
Comp. Plan
Census Tract
Number of Dwelling Units
1
Number of Buildings
1
Lot Size (Sq. Ft. /Acre)
10,000 sq. ft.
Depth
125'
Frontage
80'
Front Setback
Left Setback
RiQht Setback
Reer Setback
Additional Information
1210 Main Floor Finished
ENT USE
Square Footer
464 3rd Level Unfinished
720 4th Level Unfinished
484 Garage
1 DEP,
Buisdil Tettnlci
Date ,
7 -18 -B5
Group
R -1
Type
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
g
Ap roved
rov
Approval Cp
Hold
Environmental Health Permit Number
--1,0
7 VIC
W. 1101 College
Room 200
Planning/Zoning
N. 721 Jefferson
Permit Number
-
)-- , 8�5�
Engineers
N. 811 Jefferson
c_
•
Utilities
N. 811 Jefferson
I
Plan Review/Fire Prevention
N. 811 Jefferson
7'? `$
/
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
R i>
r^ i
1 6s
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1
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ADDRESS N. 4815 BURNS RD.
,24
C
/11
S,1 Fu •
STYLE HOME 2200-C111
LEGAL DESCRIPTION L19 B6 SUMMERFIELD EAST FIRST ADDN.
APPLICANT TUPPER INC.
JOB NO. 530
POWER W.W.P.
WATER TRENTWOOD
_ FHA CASE NO._ SCALE .1"=20'