1985, 03-22 Permit App: 00004496 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 Marne (last) (first) (m)
pgparttnerttieOnly
Tupper Inc.
2 Project Address (not Mailing Address) a Rood Name Space LP
North 4825 Burns Road 99216
3 City/Commudty
Spokane
State
WA
Subdivision/Plat
SOMME`
Name
..'
4 Aeseesor Proal No.
Portion of 15643-076 "
Lot
17
Block
6
* * * DEPARTMENT USE ONLY * * *
5 Sic Code Don. Ad. I
Zone,
-.-=rIte
1 Project No. / i r, /
I � 1 [� b
8 Dssell I
No. of Buildings
j
Sq. Ft./Acre
Depth r
1ZS`
Frontage
7 Set ads-FrontZ 5
A 1$ / /
(Rl� (
itav
COMA
CyTract
Module No.
7,77(
IM
18 Architect Firm Nemo
Street Addraea
Zip
City
State
' Phone
( )
Contact t Person
Phone N different than above
1 1
C?antractor Firm Name
Tupper Inc.
Street
Fast
Address
112973 Sprague AvP_
Zip
99216
Oty
Spokane
see
) 97R-1q,91Contact
Person
Ken or Debbie
Worse
arse No.
TirPF I R 1 7qn('
Phone If different than strove
( - )
8 C;.vnar/Agent (11 different than 01 above)
Business
Address
9 Zip
City
State
Phone
( 1
12 Review Required
N
Plan
Check (YIN)
Y
Other (YIN)
N
SEPA
Exempt
(YIN)
N
Date
33-14-85
15 Type work . g
0
Bldg
Fire
0 MH
0 Demo
!9 New
0 Add/Alter
0 Replace
0 Move
D8uDle garage
14 Describe work
*Single family residence
with double garage
10 Applicant Name
Street
Address
11 Zip
City
State
'
Phone
( )
Lender
Street Address
Zip
sty
State
Phone
( )
Contact Person
Phone If different than above
( )
Additional Information
806 Main floor finished* ie D_
816 2nd floor finished
195 main floor unfinished. . . -"4.4. i��e '
528 garage -
Application Type
(Standard unless
otherwise Indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is a21, a Permit
(Indicated approvals required in either "release' or 'release with condition'
space prior to permit Issuance.)
Environmental Health
W. 1101 College
Room 200
Conditions/ Comments'
❑ Commercial;
❑ New Construction;
❑ Additional structure;
APPL,If,ATION #
❑ Residential
❑ Bldg alteration/addition
o/3
w
Release
Release
w / cand 1
. .
Wrall
/WM,
_MEI
NMI
A
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'
0 CU, variance, zone change; shoreline; 0 fence;
0 Other
Conditions/Comments•
Engineers: 0 Commercial; 0 Residential; 0 Flood Plaln;
N. 811 Jefferson 0 drainage 0 new access/approach; 0 fence;
0 road improvements
Conditions/Commenter
/3 08'5
❑
Utilities:
N. 811 Jefferson
Conditions/Comments
Other:
Plan Exam
Fire Prev.
Conditions/Comments.
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 hold
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.4.91
ADDRESS
N. 4825 BURNS RD.
STYLE HOME
' cciRd
tEGAt DESCRDPT1ON J17 R6 SIIMMERF I FI D EAST FIRST Af)f)N _
APPLICANT TUPPER INC.
JOB NO.- 532
POWER W•W•P•
WATER TRENTW00D
FHA CASE NO. SCALE 1"=20'