1985, 03-07 Permit App: 00004388 Residence•
BUILDING 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 Name pest) (first) (m)
Department Only
Tupper Inc.
RN. Comm
2 Prajpct Address (not Meiling Address) or Road Name SPce Ztp
N. 5108 Burns Road 99216
3 City /Community
S.okane
State
WA
Subdivision/Plat Name
Summerfield East 1st Addn.
4 Aseassor Parcel No.
Portion of 35643-9076
Lot
1
Bock
9
* * * DEPARTMENT USE ONLY * * *
s Sic Cods
• • Aa. s
Zone,-._.')F
oneC F
Project No
O0
8 Dwell
/
No. of Buildings
/
Sq. Ft./Acre
• •th
/,f6
Frontage
7e
7 Set Back -Front
0
(L S-1
35
(R)S-2
/r
Rear
_....-
.16
Census Tract
Module No.
Initials
16Architect Arm Name
Street Address
Zrp
City
State
Prion
( )
Contact Person
Phone If different then above
( )
Contractor Firm Name
Tupper Inc.
Street
East
Address
12929 S•ra•ue Ave
by
99216
Ctty
Spokane
State
WA
Phone
(509 ) 928-1.91
Contac Person
Ken Tueper or Debbie Kracher
License No.
TUPPEIRI
DC
Phone if different than above
i )
8 Owner/Apert (If different than it above)
Business
Address
9 Zlp
City
State
Pawn
(
12 Review Required
N
Plan
Check (Y/N)
Y
Other (YIN)
N
SEPA
Exempt
(Y/N)
N
Date
4�-2 -84
15 Type Work a
0
Bldg
Fire
0 MH
0 Demo
r. New
❑ Add / Atter
^_ Replace
o Move
i b 1ph Cja rage
14 Describe Work
Single Family Residence
with double garage
10 Applicant Name
Tupper Inc.
I Street
East
Address
12929 Sprague Ave
11 zip
99216
or
Spokane
State
WA
Phone
(509 )928-1991
Lander l
Street Address
Zip
City
State
Prion
( )
Contact Parson
Phone If different then above
( )
Additional Information
1236 main floor
324 3rd level unfinished
546 4th level unfinished
484 double garage
Application Type
(Standard unless
otherwise Indicated)
Fast Track
E Early Start
C
DEPARTMENT APPROVALS
This is ngj a Permit
(Indicated approvals required In either 'release' or 'release with conditions'
space prior to permit issuance.)
Environmental Health
W. 1101 College
Room 200
❑ Commercial;
O New Construction;
❑ Additional structure;
APPLICATION /
❑ Residential
❑ Bldg alteration/addition
Release
Release
w/cond 1
Hold 2
ri 4,1F
r
Conditions/ Comments*
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;
❑ CU, variance, zone change; shoreline; 0 fence;
❑ Other
Conditions /Comments
Engineers: 0 Commercial; 0 Residential;
N. 811 Jefferson 0 drainage 0 new access/approach;
O road improvements
Conditions / Comments -
• Flood Plain;
❑ fence;
UtJtlties:
N. 811 Jefferson
Conditions/ Comments
Olh r:
❑ Plan Exam
Fire Prev.
Conditions / Comments
ri
ID
Project Representative
Telephone
co Agencies Performing Special Inspection:
Y O 1
4
~q E 2
O
kL C
3.
1 Indica% above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for held
mat
pt/c Asrt ► P'3403,r
D1217c
ADDRESS N. 5108 Burns Road
iSTiC
STYLE
32,0
LEGAL DESCRIPTION Lot 1, Block 9 Summerfield East 1ST ADDN
APPLICANT TUPPER INC
JOB NO. 579
FHA CASE NO.
POWER W.W.P.
WATER TRENTWOOD IRRIG.
SCALE 1" = 20' approx.