1984, 06-07 Permit App: 00000572 Residencer
BUILDING PERMIT APPLICATION WORKSHEET
(J+(� PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
return this original and our building lana to the Department of Building and Safety)
(� 9 Y � P DeP 0 �Y
1 Owner's Nome (test) (first) (m)
Tupper Inc.
Doprtment use
Rills. Comm
2 Project Address (not Meiling Address) Cr Road Name Space Zip
E. 14504 Olympic Ave. (Job #515) 99216
3 qty/Community
Spokane
State
WA
Subdivision/Plat Name
Summerfield East Addn
4 Assessor Peroel No.
Portion of 35643-9072
Lot
Btu
4
* • * DEPARTMENT USE Oq1nitials
5 Sfc Code
Ad. f
Zone
Project No.6
Dwell0
No. of Buildings
Sq. Ft./Acre
Depth
7 Set Back -Front (L),S-1
(R)S-2
Fear
0snaua Tract
Module No.
16 Ard ltect Finn Name
Street Address
ZipCity
Slate
Phone
( )
Contact Person
Plane If different then above
Owdractor Firm Name
Tupper Inc.
Sbeet Address
East 12929 Sprague Ave
Zip CRY elate Phone
99216 _ Spokane WA _(509 ) 928-i9t
Contact Peraor. ^� — Lioense No. _+^ i*x" If different than above
Ken Tupper or Debbie Kracher I TUPPEIRI79DC ( )
8 OwnerlAgent (if different than I1 above)
Business Address
9 Zip
City
State
Phone
12 Review Required
N
Plan Check (Y/N)
Y
Other (Y/N) SEPA
N
Exempt (Y/N)
N
Dote
-84
15 Type Work Bldg
❑ Fire
❑ MHm
❑ Deo
New
❑ Add/Alter
13❑ Replace
Move
pp2 ga rage41t-2
b l
14 Describe Work
Single Family Residence with double garage
10 Applicant Name
Tupper Inc.
Street Address
East 12929 Sprague Ave
11 ZipCity
99216
Spokane
State
WA
I Phone
(509 )928-1991
Lender
Street Address
Zip
City
State
Phone
Contact Person
Phone if different than above
MONSOON
Additional Information
q PhAItJ 3C�L
4474-d' u5
Application Type
(Standard unless
otherwise Indicated)
❑ Fast Track
❑ Early Start
DEPARTMENT APPROVALS
This is not a Permit
(Indicated approvals required In either 'release' or 'release with conditions'
space prior to permit issuance.)
Environmental Health ❑ Commercial; ❑ Residential
W. 1101 College ❑ New Construction; ❑ Bldg alteration/addition
Room 200 ❑ Additional structure;
APPLICATION #<
Conditions/ Comments:
❑
Planning/Zoning:
❑
Commercial; ❑ Cert. of Exemption;
Release
Release
w/cond 1
Hold 2
❑ use/zone; ` I
I
❑
CU, variance, zone change; shoreline; ❑ fence;
❑
Planning/Zoning:
❑
Commercial; ❑ Cert. of Exemption;
❑ Frontage; I I I
N. 721 Jefferson
❑
Setbacks; ❑ lot w/d; ❑ lot size;
❑ use/zone; ` I
I
❑
CU, variance, zone change; shoreline; ❑ fence;
❑
Other
Conditions / Comments:
Project Representative Telephone
Agencies Performing Special Inspection:
1.
O
W
E
O
2.
C
3
❑ ErgNners:
❑
Commercial; ❑ Residential;
❑ Flood Ptaln; ;
N. 811 Jefferson
❑
drainage ❑ new acoess/approach;
❑ fence,
❑
road improvements
Conditions / Comments:
.1
•1
I 1 Indkete above or attach condition relative to final as built approval
2 Indkote above or attach reason for hold
❑
Utilities:
N. 811 Jefferson
Conditions/ Comments:
�
Other:
❑
Plan Exam
Fire Prov.
Conditions/ Comments:
El
c
Project Representative Telephone
Agencies Performing Special Inspection:
1.
O
W
E
O
2.
C
3
I 1 Indkete above or attach condition relative to final as built approval
2 Indkote above or attach reason for hold
ys'
,
I T7I I�
�� l000 aq� o
� r
CA �
3a.o � 30.0
�s an
&arage
3o
Eii t.
37� • �a0
QrlrG ' .
/b
0LYMA/C AVE
ADDRESS E. 14504 Olympic Ave STYLE 2200-D
LEGAL DESCRIPTION Lot 2 Block 4 Summerfield East Addn
APPLICANT Tupper Inc. POWER W.W.P.
JOB NO 515 WATER Trentwood
SCALE 1" = 20'
41ll
_ Peplaa n�,J—
y
1 1
r.2
s�
t, 1000 010 o
zz 3p'
6arage
37'
. a�ive., � •
r
J64-7 7
0LI 1 /(- AVE
ADDRESS E. 14504
Olympic
Ave
STYLE
LEGAL DESCRIPTION
Lot
2
Block 4
Summerfield East Addn
2200-D
APPLICANT Tupper Inc. POWER W.W.P.
JOB NO 515 WATER Trentwood
SCALE I" = 20'