1985, 05-15 Permit App: 000005431 Residence4 -:
•
5 po
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
(Please return this original and your building plans to the Department of Building and Safety)
1 Owner's Name Oast) (first) (m)
Department Use Only
Tupper Inc.
Comm
2 Project Address (not Mailing Address) v Road Name Space Z P
E. 14819 Olympic Ave. 99216
3 City/Community
Spokane
State
WA
Subdivision/Plat Name
SUMME ST ADDN_
4 Assessor Parcel No.
Portion of 35643-9076 •
Lot
2
Block
* * * DEPARTMENT USE ONLY * * *
9
5 Sic Code 12tnSACt.#
Zone S P H Project No
6 Dwell it
1
No. of Bul dirge
1
Sq. Ft./Acre f th
Frontage
7 Set Bads -Front
(.)S-1
(R)8-2
Rear
Census Tract
Module No.
Initials
C '7r r a)
16 Architect Firm Nene
Street Address
Zip
Citi'
State
Phone
( )
Contact Ptraon
Phone if different than above
( )
Contractor Firm Name
Tupper Inc.
Street Address
Fa t- 17979 Sprague AVP
Zip
99216
City
Spo ane(
State
Phone
5D9 ) 975-19,91
contact Person
Ken or Debbie
License No.
Tt(PPF1R179DC
Phone If different than above
( — )
8 Owner/Agent Of different then 11 above)
Business Address
9 Zip
City
State
Plane
( )
12 Review Required
N
Plan Shack (YIN)
Y
Other (YIN) I SEPA Exempt (Y/N)
N N
Date
f -fib -"6
15 Type Work IN Bldg
0 Fire
0 MH
❑ Demo
IS New
❑ Add/Alter
0 Replace
0 Move
Diu garage
14 Describe Work •
Single familq residence with double garage
10 Applicant Name
Street Address
11 Zip
qty
State
Phone
( )
Lender
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone If different than above
( )
Additional Information
1236 Main Floor Finished
324 3rd Level ' finished
,
546 4th Level Unfinished
484 Garage
•
•
Application Type
(Standard unless •
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is nit a Permit
(Indicated approvals required in either 'release' or 'release with conditions'
apace prior to permit issuance.)
0
Environmental Health
W. 1101 College
Room 200
Conditions/Comments-
0
onditions/Comments-
❑ Commercial;
❑ New Construction;
❑ Additional structure;
APPLICATION 1
❑ Residential
❑ Bldg alteration/addition
Release
Release iw/cond 1
Hold 2
0
Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage;
N. 721 Jefferson 0 Setbacks; 0 lot w/d; 0 lot size; 0 use/zone;
0 CU, variance; zone change; shoreline; 0 fence;
Conditions/Comments-
._
0
onditions/Comments-
❑ Other
Engineers: 0 Commercial; 0 Residential;
N.811 Jefferson 0 drainage 0 new access/approach;
0 road improvements
Conditions /Com ments-
'/?4- �6/
❑ Flood Plain;
O fence;
Utilities:
N. 811 Jefferson
Conditions/Comments-
0 :
onditions/Comments-
Other:
64
c
cb
LI
m
c
u O
03
F`— E
coTA 0
2
LL
Plan Exam
Fire Prev.
Conditions/Comments-
Project Representative
Agencies Performing Special Inspection:
1
2
3
Telephone
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
ADDRESS
V/II?/‘ /41 1/1-
41'
,J --/r00 gal
C
v
;
• fri",e: •
E. 14819 Olympic Ave
STYLE HOME
LEGAL DESCRIPTION Lot 2 Block 9 Summerfield East 1st Addn.
APPLICANT Tupper Inc]
JOB NO 580
POWER
W.W.P.
WATER Trentwood
FHA CASE NO SCALE
1"-20' approx
,