1985, 10-22 Permit App: 00008408 Residence(THIS IS NOTA PERMIT)3�,.� Vo
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 (,;ans to the Department of Building and Safety)
SHADED AREAS ARE FOR DEPARTMENTAL USE
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Protect Number V Q -)Q
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Owner's Name LAST FIRST MI
TUPPER INC.
Project Address (Street Name & Number) Zip
N. 5113 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.
Add
E.
ess
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
1 Zip
Phone
( )
Contact
Business Phone
Lender
Address
City
State
Zip
Phone
( 1
Describe Work
Single family residence with double garage
Res 1 Cornrn
j
• Subdivision/ Piet Name/Short Plat Number
SUMMERFIELD EAST 1ST ADDITION
Assessor Perm. Number
Portion of #35643-9076 ,_ S6. 4/- 62.43
Lot
8
Block ! Plat Number
6 I
Pertinent File Numbers
Zone
Comp. Paan 1 Census Tract
Number of Dwelling Units
1
Number of Buildings
1
Lot Size (Sq. Ft./Acre)
11,207 ap• rox.
Depth
Frontage
Front Setback
Left Setback
Right Setback
Rear Setback
Additional Information
1236 main floor finished
DEPAPTNIENT USE
Square Footage
324 3rd level unfinished V 7 b
546 4th level unfinished
k84 garage
Building Technician Date
Group
Type
DEPARTMENTAL REVIEW
I certify that 1 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 !Cryo c�
Date /C __ 0 A
Approved
Cond.
Approval
Hold
Environmental Health Permit Number 4 7ty
••
1 W. 1101 College
Room 200 Is
at
111
Planning/Zoning
N. 721 Jefferson
Engineers Permit Number
/D/z-
///
--Z
N. 811 Jefferson P 64
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Utilities
N. 811 Jefferson
I
Plan Review/Fire Prevention
N. 811 Jefferson
Other (SEPA/Critical Material/etc.)
Fast Track/Special Inspection information
Project Representative
Phone
Address
I certify that 1 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 !Cryo c�
Date /C __ 0 A
1
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1304
ADDRESS N. 5113 BURNS RD.
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STYLE HOME 3200-C
1307
LEGAL DESCRIPTION L8 B6 SUMMERFIELD EAST FIRST ADDN.
APPLICANT TUPPER INC. POWER W.W.P.
JOB NO. 578
WATER TRENTWOOD
FHA CASE NO. SCALE 1"=20'