1985, 10-24 Permit App: 00008330 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)
Project Number 8 '53c3
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Owner's Name LAST FIRST MI
TUPPER INC. •
Project Address (Street Name & Number) Zip
N. 5021 Burns Rd., Spokane, Washington 99216
Applicant
TUPPER INC. E.
Address
12929 Sprague Ave.
City
Spokane
State
Washington
Zip
99216
Phone
(509 ) 928-1991
Business Phone
(509 > 928-1991
Contractor /Agent
TUPPER INC. E.
Address
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 f Engineer
Address
City
State
Zip
Phone
( )
Contact
s
Business Phone
( )
Lender
Add ess
City
State
I Zip
Il
Phone
$aietkeilAsteriC . ' -
f S.i:ngle-Famil_y Residence
Flee.
Comm.
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h.SU SI ERFiELD EASZ 1ST ADDITION
A>. Parcel Nurtger
'35644-2609
Lot
9
Block
6
Plat Number
Pertinent Fite Numbers
Zone
Comp. Plan
Census Tract
Number of Owening Units
1
Number of Buildings
1
Lot Size (Sq. Ft./Acre)
Depth
Frontage
front setback
Lett Setback
Right Setback
Rear Setback
Additional Information
1210 main floor
1 DEPARTMENT USE I
Square Footage
1184 unfinished basement .
484 garage 10.2e
0, -
Building
Building Technician
Date
Group ! Type
i
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 V —
Approved
pp
Apprrovov al
Hold
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Environmental Health Permit Number s-17/_ 3
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W. 1101 College
Room 200
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Planning/Zoning
N. 721 Jefferson
Permit Numberr^
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Engineers
�l
N. 811 Jefferson /-�iir 4 7-.
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•
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 V —
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ADDRESS N. 5021 Burns Rd. STYLE HOME 2200-Cl1l
LEGAL DESCRIPTION L9 B6 SUMMERF}ELD EAST FIRST ADDN.
APPLICANT TUPPER INC.
JOB # 577
FHA CASE #
POWER W.W.P.
WATER TRENTWOOD
SCALE 1''~20'