1984, 04-23 Permit App: 00005064 ResidenceBUILDING 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 (W) (first) (m)
Oepertrrent Use Only
Tupper Inc.
Fbe• Comm
2 Project Address (not Mailing Address) cc Road Name Space by
E. 14820 Olympic Ave. 99216
3 City/Community
Spokane
State
WA
Subdivision/Plat Name
SUMME D EAST FIRST ADDN_
4 Assessor Parcel No.
Portion of 35643-9076
Lot
1
Block
* * * DEPARTMENT USE ONLY * * *
8
5 Sic Code jZDnSACt. it
Zone Project No. r'" r.
6 Deed D
No. of Buildings
Sq. Ft./Acre
Depth
Frontage
7 Set Back -Front -
.)S-1
(R)S-2
Rear
Cereus Tract
Module No.
Initials
16 Architect Rrm Name
I Street Address
Zip
Qty
State
Phone
( )
Contact Parson
Phone if different than above
( )
Contractor Firm Name
Tupper Inc.
Street
_Ea
Address
1- 17979 Sprague AVP
Zip
99216
qty
Spokane
State
Phone
(5as ) 97R-1991
Contact Parson
Ken or Debbie
Wines No.
T PFIR179nC
Phone If different than above
(— )
8 Owner/Agent ()f different than 91 above)
Business
Address
9 Zip
Qty
State
Phone
( )
12 Review Required
N
Plan
Check (Y/N)
Y
Other (Y/N)
N
SEPA Exempt
(Y/N)
N
Orta
�j�p—y,cg— $�
• 15 Type Work g
❑
Bldg —
Rre
M
0 H
0 Dere
19 New •
0 Add/Atter
0 tee
0 Move
pgU 1 e2garage
14 Describe Work
Single family 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
324 3rd Level Finished
546 4 Level Unfinished
484 Garage
*
•
. __� •
Application Type
(Standard unless •
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is ngj a Permit
(Indicated approvals required in either "release" or "release with conditions'
space prior to permit issuance.)
0
Environmental Health
W. 1101 College
Room 200
❑ Commercial; 0 Residential
❑ New Construction; 0 Bldg alteration/addition
❑ Additional structure+D3�iy
APPLICATION
Release
Release
w/cond 1
Hold 2
J, Q _
1 -L3 -'S
Conditions /Comments•
0
Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage;
N. 721 Jefferson 0 Setbacks; 0 tot w/d; 0 lot size; 0 use/zone;
❑ CU, variance, zone change; shoreline; 0 fence;
❑ Other
Conditions/ Comments.
Engineers: 0 Commercial; 0 Residential;
N. 811 Jefferson 0 drainage 0 new access/approach;
O road improvements
Conditions /Com men is•
❑ Flood Plain;
❑ fence;
,5109 co/.
0
Utilities:
N. 811 Jefferson
Conditions/ Comments•
Other:
0
Plan Exam
Fire Prev.
Conditions/Comments-
Project Representative Telephone
Agencies Performing Special Inspection:
1
2
3
1 Indicate above or attach conditions relative to final as built approval
• • 2 Indicate above or attach reasons for hold
.- •
•
i/�
30
3/'1
ADDRESS E. 14820 Olympic Avenue STYLE HOME 3200
LEGAL DESCRIPTION Lot 1 Block 8 Summerfield East First Addition
APPLICANT Tupper Inc.
JOB NO 581
POWER W.W.P.
WATER Trentwood
FHA CASE NO SCALE 1"': 20'