1986, 03-31 Permit App: 00011015 Residence(THIS IS NOT A 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)
.7 r1HVCI1 Nr1C/ HPIC rvrt L?t tin 1 MCIV 1 HL UJC
Proiec- Number / /CJ ) /5
Owner s Name LAST FIRST MI
TUPPER INC.
Project Address (Street Name & Number) Zip
N. 4917 Lucille Rd. Spokane, Washington 99216
Applicant f
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.
Address
E.
12929 Sprague Ave.
City
Spokane
late
• Washington
Z p
99216
Phone
(509 1928-1991
Contac'
Ken or Debbie
License Number (Required)
TUPPEIR179DC
Business Phone
1509 '928-1991
Archi tect i Engineer
Address
City
State
I Zip
Phone
(
Contact
Business Phone
Lender
Address
City
State
Zip
Phone
1
tlesatribe Wbrk
SFR
Res.
Comm.
_
Subdivfa;on/ Pia; Nare!Short Plat Numoer 3 1 4V cis 75 / fJv-�d�/ / E/n7.
SUMMERFIELD EAST 2ND ADDITION
Assessor Parcel Number
Lot
1
Block
10
Plat Number
Pertinent File Numbers
Zones .
Comp. Plan
Census Tract
Number of Dwelling Units
1
Number of Buildings
1
Lot Size (So. Ft.iAcre)
10,000
Depth t
i 27S
Frontage
ICr
Front Setbackt
Left Setback
Right Setback
Rea: Setback
Addiliona! Information
996 main floor
[ DEPARTMENT USE
Square Footage
948 unfinished basement
• .. .. -
II . . - -. .-
Building Technician Date
JON 0) ' I3 -.7;-n
i
Group 1 Type
- 3 1 u(V
❑
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 c5 y_c
Date 2 / - 6 6
Approved
Approval Appro
Hold
-' Environmental Health Permit Number -
4L -30-f310
W. 1101 College
Room 200
LYAJCµ
Planning/Zoning
N. 721 Jefferson
Permit Number
Engineers
N. 811 Jefferson
5-12-86
gDWA20S
Utilities
N.811 Jefferson
1
Plan Review/Fire Prevention
N. 811 Jefferson
Other (SEPA/Crlticai Material/etc.)
Fast Track/Special Inspection Information
Project Representative
Phone
Moiress
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 c5 y_c
Date 2 / - 6 6
/
•
•
1
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27.7
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ADDRESS N. 4917 LUCILLE RD.
2
LEGAL DESCRIPTION L1 B10 SUMMERFIELD EAST 2nd ADDITION
APPLICANT TUPPER INC.
JOB # 582
FNA CASE
PERMIT °
STYLE 2200-D
POWER WWP
WATER TRENTWOOD
SCALE 1" = 20'