1986, 03-31 Permit App: 00010980 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)
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Project Number
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Owner's Name LAST FIRST MI
Tupper, Inc.
Project Address (Street Name & Number) Zip
N. 4907 Lucille Rd. 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.
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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
Add ass
City
State
Zip
Phone
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SubdtvtsionlPtai Name/Short Plat Number y 7,J /)C,47/G,% 7-7/6-,-4.9./-7-- (
Summ f'-ld r,d 'd.i i.
Assessor Parcel Number
Lot
3
Block
10
Plat Number
Pertinent File Numbers
Zane 1 1�
i'
Comp. Plan
Census Tract
Number of Dwelling Units
1
Number of Buildings
1
Lot Size (SQ. Ft./Acro)
10 000
Depth I
12S-•
Frontage
ec
Front Setter l
7 U
Left Setback
P )
Right Setback Rear Setback
I j ) 1 ._ r
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Additional information
1S main floor
DEPARTMENT USE
Square Footage
464 3rd level unfinished
720 - - '' . .
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G..
icing Technician
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Dots
3- 3 I a(
Group
Type
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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 'N
Date 2_3f_ g
Approved
Cond.
Approval
Hold
Environmental Health Permit Number
W. 1101 College
Room 200
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 Signature 'N
Date 2_3f_ g
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4,1
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ADDRESS N. 4907 Lucille Rd.
STYLE 2200 - Clll
LEGAL DESCRIPTION L3 B10 SUMMERFIELD EAST 2ND ADDITION
APPLICANT TUPPER POWER WWP
JOB = 584 WATER TRENTWOOD
FHA CASE = SCALE 1"=20'