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1985, 10-11 Permit App: 00008002 Residence(THIS IS NOT A 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 gOb2 Owner's Name TUPPER INC. LAST FIRST MI Project Address (Street Name & Number) E. 11821 Railroad Ct. Spokane, Washington 99206 Zip Applicant TUPPER INC. Address E. 12929 Sprague Ave. City Spokane State Washington Zip 99216 Phone (509 ) 928-1991 Business Phone ( 509 ) 928-1991 Contractor/Agent TUPPER INC. Address E. 12929 Sprague Ave. City Spokane Contact Ken or Debbie State Washington Zip 99216 Phone ( 509 r 928-1991 License Number (Required) TUPPEIR179DC Business Phone ( 509) 928-1991 Architect I Engineer Address City Contact Lender City State Zip Phone Business Phone Address State st !Addit ion Zip of CwsHtrig Number of Buildings 19 Phone Comp.Zone Plan Plat Census Tract, Lot Size (Sq. Ft./Acre) Frontage Left Setback RightSetback Rear Setback Additional InformaIn 940 mainfIoor 40 unfinished basement w co 3 s-- 2 r 3. ware Footage 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 Approved Cond. A Approval Hold Environmental Health Permit Number Citi .101, tLi9'2 ICI'L,,/1 W. 1101 College Room 200 Planning/Zoning N. 721 Jefferson Permit Number f f-$ Engineers N. 811 Jefferson /=N4-4 9 Utilities N. 811 Jefferson 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 /1. O 10' 7 ll)C i- /Qs a r2L.0 c ,721 G' ecp/oce n1fLL — — 0' 11.41 oce7; dio.f- ,F ' ry o f too 4'o :9 4o 1G 6 j g, P i '�alG6� �i*Z`LY' El BULDERS COPY T v f • T. OF C OR oFST, 0R DDRESS E. 11821 Railroad Court �� �'STYLE940CS elevation EGAL DESCRIPTION L19 81 Pines West First Addition APPLICANT TUPPER INC. JOB # 883 FHA CASE # S O 3 7.3/0 POWER WWP WATER Irvin SCALE 1"=20'