1985, 08-07 Permit App: 00006734 Residence • (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)
SHADED AREAS ARE FOR DEPARTMENTAL USE
Project Number
(0,1,51—
Owner's Name LAST FI RST MI
Tupper Inc.
Project Address(Street Name&Number) Zip
E. 14907 Wabash Ct. Spokane, Washington 99216
Applicant Address
Tupper Inc. E. 12929 Sprague
City State Zip Phone
Spokane Washington 99216 ( 509) 928-1991
Business Phone
Contractor/Agent Address
Tupper Inc. E. 12929 Sprague
City State Zip Phone
Spokane Washington 99216 ( 509) 928-1991
Contact License Number(Required) Business Phone
Ken or Debbie TUPPEIR179DC ( 509) 928-1991
Architect/Engineer Address
City State I Zip Phone
I ( )
Contact Business Phone
Lender Address
City State i
Zip Phone ( )
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DEPARTMENTAL REVIEW
Approved CpApproval Hold
Environmental Health Permit Number $S 1❑ W. 1101 College 41i i
Room 200 v
Planning/Zoning
❑ N.721 Jefferson -
Engineers Permit Number F/1/Q LJS+'Y $- $S
❑ N.811 Jefferson `-A101
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
• - - . � c ,' 12/5.
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ADDRESS E. 14907 WABASH CT. STYLE HOME 2200-C11
— -- -LEGAL DESCRIPTION - 13 88 SUMMERFIELD EAST FIRST ADDN.
APPLICANT TUPPER-1NC. POWER W.W.P.
JOB NO. 541WATER TRENTWOOD
--FHA CASE NO. -- - - -- SCALE 1"=20'