1985, 06-20 Permit App: 00006013 ResidenceBUILDING PERMIT APPLICATION WORKSHEET �`2,
` 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 Oast) (first) (m)
Tuaaer Inc.
[lagan Only
Comm
2 Project Address (not Malting Address) or Road Name Space Zip
N. 4917 Burns Rd. 99216
3 city/Cormu ity
Spokane
State
WA
Subdivision/
SUMME
Plat Name
FIELD EAST FIRST ADDN_
4 Assessor Parcel No.
Portion of 64 - 0
Lot
15
Block
6
* * * DEPARTMENT USE ONLY * * *
5 Sic Code Zone Act. 1
Zone
C FR
Project No. // 77
&6)/J
8 Dwd/
1
No. of Buildings
Sq. Ft./Acre
Depth/
/26
Frontage
Rio
7 Set Beck -Frame
a)S-1
(R)s-2
Rev
O neue Tract
Module No.
Ingle*.
18 Architect Firm Nemo
I Street Address
Zlp
City
State
Phone
( )
Contact Person
Phone 0 different than above
( )
Contractor Firm Name
Tupper Inc.
Street Address
Ea 1- 12929 Sprague AVP
Zip
99216
City
Spokane
State
Phone
(5a9 ) 9�R-19 1
Conned Person
Ken or Debbie
Lionise No.
TI)PPEIR17cinr
Phone If different than above
( - )
8 Owner/Agent (H different than H above)
Business Address
9 Zip
City
State
Phone
( )
12 Review Required
N
Plan Chock (YIN)
Y
Other (V/N)
N
SEPA Exempt (YIN)
N
Date
v —/8 '$0—
15 Type Work . i( Bldg
0 Fire
0 MH
DOM
0 De
iS New
0 Add/Alter
❑ Replace
0 Move
D�uD l epy��r garage
14 Describe Work . _
'Single family residence With double garage
10 Applicant Meme
Street Address
11 Zip
City
State
Phone
( )
Lir
Street Address
Zip
City
State
Phone
( )
Contact Fin
Phone If different than above
( )
Additional Information
1236 Main Floor Finished
324 3rd Level Unfinished
546 4th Level- Unfinished
484 Garage
*
1
DEPARTMENT APPROVALS
D
Application Type
(Standard unless •
otherwise indicated) _
Fast Track
Early Start
1rim 1*Ilya, areturn.
(indicated approvals required in either "release" or "release with conditions"
issuance.)
space prior to permit
Release
Release
w/cond 1
Hold 2
❑
Environmental Health 0 Commercial; 0 Residential•
W.1101 College 0 New Construction; 0 Bldg alteration/addition
'•�1�
C
Room 200 0 Additional structure;
APPLICATION M g5-- -- e761-/
Conditions/Comments*
•
Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage;
0 lot w/d; 0 lot size; 0 use/zone;
N. 721 Jefferson 0 Setbacks;
0 CU, variance, zone change; shoreline; 0 fence;
❑ Other
Conditions/Comments:
•
■
1
Engineers: ❑ Commercial; 0 Residential; 0 Flood Pial ,
if
;
N. 811 Jefferson 0 drainage 0 new access/approach; 0 fence;
❑ road improvements �� „/
Conditions/ Comments* / �/
•
Utilities:
N. 811 Jefferson
.
Conditions/Comments •
'
Other:
_
7
•
Plan Exam
Fire Prev.
I
Conditions/Comments:
i
n
a�
Project Representative Telephone
3
D
-
Agencies Performing Special Inspection:
1
o
o m
L.E
2
p O
C C
L
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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AD[iRESS North .1917_.Burns ! i STYLE
HOPIE 3200 "c,
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f 1 DESCiRI PST ION i J 15 SL»tMERF TELA EAST
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