1985, 12-20 Permit Ap: 00009208 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)
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Project Number
Owner's Name LAST FIRST MI
TUPPER INC.
Project Address (Street Name & Number) Zip
N. 4923 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
( 1
Contact
•
Business Phone
( )
Lender
Address
City
State
Zip
Phone
( )
R
Iles
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Piet lilvkll/toEt Piet Number
- SUMMERS 1'ELD EAST 1ST ADDITION odic A
Assessor Parcel Number •
35644-2613 '
Lot
13
Stock
6
Plat Number
Ptir+ertt File Numbers
Zone
I`
Comp. Plan
Census Tract
Number of Owetl ng unite
!
Number of Buildings
/
Lot Size (Sq. Ft./Acre)
Depth
�
Frontage
-*oat Setback
Left Setback
Right Setback
Rear back
Additional Information
9g6` Main Floor
I..
[ DEPARTMENT USE
Square Footage
'-448 , 3rd S 4th level unfinished
484 garage
Building Technician
4%.1-4)
Date
r2 2c�-
Group
is...--,...„
Type
VN
ir
DEPARTMENTAL REVIEW
Approved
Cond.
Approval
Hold
Environmental Health Permit Number i3 ---/?1,-.3-7,
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❑
W. 1101 College
Room 200
•
Planning/Zoning
N. 721 Jefferson
Permit Number
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•
Engineers
N.811 Jefferson VA-% 7c37
\
❑
Utilities
N. 811 Jefferson
[]
Plan Review/Fire Prevention
N. 811 Jefferson
❑
Other (SEPA/Critical Material/etc.) _
f1
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 /-'``y—
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ADDRESS
N. 4923
BURNS RD.
AP
LEGAL DE SCR I PT I ON
APP 1 CANT 'TUPPER INC.
STYLE HOME 22001 B
L13 86 SUMMERF I ELD EAST FIRST ADDN.
• •
POWER W.W.P.
— JOB NO.
536
FHA CASE NO.
1 WATER TRENTWOOD
SCALE 1"=20'