1986, 04-30 Permit App: 00012360 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)
JrtAUtU AhtAJ AI1t rum UtrAr1 I Mtn4 I AL LJt
Project Number
Owner's Name LAST FIRST MI
TUPPER, INC.
Project Address (Street Name & Number) Zip
N. 4902 Lucille, Spokane. Washington 99216
Applicant
TUPPER, INC.
Address
E. 12929 Sprague Avenue
City
Spokane
State
Washington
Zip
99216
Phone
(509 ) 928-1991
Business Phone
( 5n9 ' 92R-1991
Contractor /Agent
TUPPER. INC.
Address
E.
12929 Sprague
City
Spokane
State
Washington
Zip
99216
Phone
( 509) 928-1991
Business Phone
( 509) 928-1991
Contact
Ken or Debbie
License Number (Required)
TUPPEIR179DC
Architect; Engineer
Address
City
State Zip
A(
Phone
)
Contact
Business Phone
( 1
Lender
Add ess
City
State
Zip
Phone
( 1
+ • tbeillMrk
SFR 1K' . - - .-. a• s -- . a. i -
flet.
Comm
SUbdMs on! Plat Name/Short Plat Number
SUMMERFIELD EAST 2nd ADDITION 356449075 PORTION THF
FOF
Assessor Parcel Number
35644-9075 PORTION THEREOF
Lot
2
Block
11
Pial Number
rPertinent File Numbers
pone
Comp. Plan
Census Tract
Number of Dwelling Units
1
Number of Buildings
1
Lot Size (Sq. Ft. /Acre)
Right
1s��
Rear
Dept
Setback
Frontage
Front SetbackLek
Setback
Additional Information
99A tna i n f lo.o r
[ DEPARTMENT USE
Square Footage
464 third 1PuPl
(2 3(
484 fourth level
r4f *405�
484 garage
U6=g2U
fs„ 4c.'
100 uncovered deckvA'n
, 464
Group
Type
Bultding Technlalan
I Dote
Environmental Health
❑ W. 1101 College
Room 200
DEPARTMENTAL REVIEW
Permit Number
rCp
prove!
Appr ved
Hold
Planning/Zoning
❑ N. 721 Jefferson
Engineers
❑ N. 811 Jefferson
Permit Number
4%l8ao
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 ' i Date
r
4.
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Address 4902 Lucille .13oad. - _ Style: _ 2200-B
Legal Description: L2_611 Summerfield East 2nd Addition
Applicant: Tupper, Inc. . Power : WWP
Job #: 598 Water: Trentwood
.„.
FHA Case #: ; . Scale: 1" = 20'
Permit #:
'