1985, 09-11 Permit App: 00007423 Residence35w -r,
(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)
SHADED AREAS ARE FOR DEPARTMENTAL USE
Project Number
Owner's Name
Tu. mer Inc.
LAST
FIRST
MI
Project Address (Street Name & Number)
E. 1461 01 .ic Avenue
S.okane Washin•ton
Zip
99216
Applicant
Tupper Inc.
City
Spokane
State
Washington
Zip
99216
Address
•
Phone
( 509) 928-1991
Contractor/Agent
Tupper Inc.
City
Spokane
State
Wash i*ngton
Contact
Ken or Debbie
Architect /Engineer
City
Business Phone
Add ess
E. 12929 Sprague Avenue
Zip
99216
License Number (Required)
TUPPEIR179DC
State
Zip
Phone
( 509 928-1991
Business Phone
( 509) 928-1991
Address
Contact
Lender
City
State
Zip
Phone
(
Business Phone
Address
Phone
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
Date J
Ap roved
pp
Apprrovov al
Hold
Environmental Health Permit Number/1�
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i�
'
W. 1101 College
Room 200
_
Planning/Zoning
N. 721 Jefferson
Permit Number
y. /./.-,T,S
Engineers��A
N..811 1 Jefferson
1
Utilities
N. 811 Jefferson
I
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
Date J
•
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J
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ADDRESS E. /ii6/7 OLYMPIC AVE.
STYLE HOME .02,zna-i)
LEGAL DESCRIPTION L2 B5 SUMMERFIELD EAST FIRST ADDN.
APPLICANT TUPPER INC.
JOB NO. 563
FHA CASE NO.
POWER
WATER
SCALE
W.W.P.
TROTWOOD
1"---201