1985, 10-22 Permit App: 00008407 Residence •
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(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 f„r{4 03
Owner's Name LAST FIRST MI C
TUPPER INC.
Project Address(Street Name&Number) Zip
E. 14916 Summerfield Ct. Spokane, Wa. 99216
Applicant Address
TUPPER [NC. E. 12929 Sprague Ave.
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City State Zip Phone
Spokane Washington 99216 ( 509 ) 928-1991
Business Phone
( 509 ) 928-1991
Contractor/Agent Address
TUPPER INC. E. 12929 Sprague Ave.
City State Zip Phone
Spokane Washington 99216 ( 509 ► 928-1991
Contact License Number(Required) Business Phone
Ken or Debbie TUPPIER179DC ( 509 928-1991
Architect/Engineer Address
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City State Zip Phone •
( )
Contact Business Phone
( )
Lender Address
City State rip
Phone
( 1
Describe Work Res. Comm.
Single Family Residence
Subdivision/Plat Name/Short Plat Number
SUMMERFIELD EAST 1ST ADDITION
Assessor Parcel Number Lot Block Plat Number
35644-2819 19 8
Pertinent File Numbers Zone Comp.Plan Census Tract
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Number of Dwelling Units Number of Buildings Lot Size(Sq.Ft./Acre) Depth Frontage
1 1
Front Setback Left Setback Right Setback Rear Setback
Additional Information Square Footage
1236 main floor
870 basement unfinished
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484 gArag,
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Building Technician Date Group F Type
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DEPARTMENTAL REVIEW
Approved pp
Apprrovov al Hold
Environmental Health Permit Number ��y� ice-
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O 1101 College
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Room 200
Planning/Zoning
0 N.721 Jefferson
Engineers Permit Number ri eb . �s
❑ N.811 Jefferson F/YA
Utilities
O 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 \_fGZ'.t�C %u r'` Date ( � ` `S�
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SUM)111-eF/E L D C7 /
ADDRESS E. 14916 SUMMERFIELD CT. STYLE HOME 3200
LEGAL DESCRIPTION L19 68 SUMMERFIELD EAST FIRST ADDN.
APPLICANT TUPPER INC. POWER W.W.P.
JOB NO. 557 WATER TRENTWOOD .
FHA CASE NO. SCALE 1"=20'