1985, 09-11 Permit App: 00007431 Residence-2
(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
Owner's Name LAST FIRST MI
Tupper Inc.
Project Address (Street Name & Number) Zip
E. 14723 Olympic Avenue Spokane, Washington 99216
Applicant
Tupper Inc.
Address
E. 12929 Sprague Avenue
City
Spokane
State
Washington
Zip
99216
Phone
( 509) 928-1991
Business Phone
( 509) 928-1991
Contractor/Agent
Tupper Inc.
Address
E. 12929 Sprague Avenue
City
Spokane
State
Washington
Zip
99216
Phone
( 509) 928-1991
Contact
Ken or Debbie
License Number (Required)
TUPPEIR1Z9DC
Business Phone
( 509) 928-1991
Architect /Engineer
Address
City
State
I Zip
Phone
( )
Contact
Business Phone
( )
Lender
Address
City
State Zip 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 SignaturetG-cam_
‘7:-6
Date /
Ap•/raved Approval
Cond.
Hold
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Environmental Health Permit Number y -`!7 / /
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W. 1101 College
Room 200
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11
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Planning/Zoning
N. 721 Jefferson
Permit Number
9-,ri w
Engineers
N. 811 Jefferson / / "S-A d
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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 SignaturetG-cam_
‘7:-6
Date /
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ADDRESS
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E. 11+723 OLYMPIC AVE.
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STYLE HOME 2200-B
LEGAL DESCRIPTION L7 65 SUMMERFIELD EAST FIRST ADDN.
APPLICANT TUPPER INC
JOB NO. 568
FHA CASE NO.
POWER
W.W.P.
WATER TRENTWOOD
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