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1986, 03-31 Permit App: 00010979 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©q*79 !! Owner's Name LAST FIRST MI Tupper, Inc. Project Address (Street Name & Number) Zip N 14902 Lucille Spokane Wa. 99216 Applicant Tupper, Inc. Address E. 12929 Sprague City Spokane State WA Zip 99216 Phone ( 509) 928-1995 Business Phone ( 509) 928-1995 Contractor /Agent Tupper, Inc. Address E. 12929 Sprague City Spokane State WA Zip 99216 Phone ( 509) 928-1995 Contact Ken or Debbie License Number (Required) TUPPEIR179DC Business Phone ( 509)928-1995 Architect/ Engineer Address City State Zip Phone ( ) Contact Business Phone ( Lender Address City State Zip Phone 1 I 'Ties. Comm. _ 75— `%2'%711-) 7A �, ; (, •Subdivision/Plat Name/Short Plat Number -39z7//it'?; Summerfield East 2nd Addition Assessor Parcel Number Lot 2 Block 11 Plat Number Pertinent File Numbers Zone Comp. Plan Census Tract Number oh Dwelling Units 1 Number of Buildings 110,579 Lot Size (Sq. Fl./Acre) Depth Frontage _front Setback �, , Left Setback Right Setback Rear Setback Additional Information 1236 main floor DEPARTMENT USE Square Footage 324 3rd level unfinished 546 4th level unfinished 484 garage Building TechniciaDae/ Z* < 4g- +P Type }� l O E 0 0 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 Signaturec\ler-7-4--c-71t Date S 37 a � Approved pond. Approval Hold Environmental Health - Permit Number W. 1101 College Room 200 VI Planning/Zoning N.-721 Jefferson Permit Number Engineers N. 811 Jefferson 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 Signaturec\ler-7-4--c-71t Date S 37 a � 70.06 S' n" Go' Gok. Go' 1 { /so0 00 / V I .2.-416011141 1.I r /y' / ' F' me ,44- 33.1 N 44 ,D . qt° y(r) r\ jkti //' Arc' - // y3.1‘ :/ may L . ADDRESS N. 4902 Lucille Rd. STYLE 3200/4th LEGAL DESCRIPTION L2 B11 SUMMERFIELD EAST 2nd ADDITION APPLICANT TUPPER INC. POWER WWP JOB # 598 WATER TRENTWOOD FHA CASE # SCALE 1"=20' PERMIT #