1985, 02-15 Permit App: 00004105 Residence - e 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
(last) (first) (m)
Tu•e e r Inc.
Department Only:
2 Project Address(not Mailing Address)a'Road Name CIIMI/IIIII
p Comm
N. 2712 Woodward Rd. Space Zip
3 City/Community 99206
State Subdivision/Plat Name
Spokane WA
4 Assessor Parcel No. Sunny Valley Acres
Lot Block
09542-0847
13 1 * * * DEPARTMENT USE ONLY * * *
5 Sic Code Zone Act.#t Zone
Project No.
6 Dwell M
Act-, X05
No.of Buildings
Sq.Ft./Acre Depth
r��/ Frontage
7 Set Back-Front 4; i
Elli(R)S-2 li. Census Tract
35
)S G Module No.
* 16 Architect Firm Name tJ *Mil I
Street Address *
Zip City
State Phone
Contact Person ( )
Phone If different than above
Contractor Firm Name ( )
Tupper Inc. Street Address
Zip CityE. 12929 Sprague Ave
99 216 State Phone
Spokane WA ( 509 ) 928-1991
Contact Person
License No. Phone if different than above
Ken Tupper or Debbie Krache TUPPEIR179DC ( )
8 Owner/Agent(if different than#1 above) 509 928-1991
Business Address
9 Zip City
State Phone
12 Review Required Plan ( )
Check(Y/N) Other(Y/N)
SEPA Exempt(Y/N) Date
N
Y
15 Type Work % Bld N N
Bldg ❑ MH X New
❑ Fire ❑ Replace ❑ Other
❑ Demo ❑ Add/Alter
14 Describe Work ❑ Move
Single family residence
10 Applicant Name
Tupper Inc. Street Address
11 Zip
City E. 12929 Sprague Ave
* 99216 Spokane State Phone
Lender WA (509 ) 928-1991
Street Address *
Zip
City State
Phone
Contact Person ( )
Phone if different than above
Additional Information ( )
979 main floor
932 unfinished basement
32 uncovered deck
s .L
_
DEPARTMENT APPROVALS t
This is nota Permit
Application Type
(Standard unless (Indicated approvals required in either"release"or"release with conditions"
otherwise indicated) space prior to permit issuance.) !
❑ Fast Track Release
❑ Early Start R- ease w/cond 1 Hold 2
It
❑ Environmental Health ❑ Commercial; ❑ Residential ' /�/
W.1101 College D New Construction; ❑ Bldg alteration/addition
ei Room 200 ❑ Additional al`structure; 2 APPLICATION# �' - �`� ./^ `
Conditions/Comments: viv/..,. 4-p-d_z1-4---74--
❑ Planning/Zoning: ❑ Commercial; ❑ Cert.of Exemption; D Frontage; I I I
0 use/zone;
N.721 Jefferson ❑ Setbacks; 0 lot w/d; 0 lot size;
O CU,variance,zone change;shoreline; 0 fence;
❑ Other
Conditions/Comments:
45,
❑ Engineers: 0 Commercial; ❑ Residential;
0 Flood Plain; t / I
N.811 Jefferson 0 drainage ❑ new access/approach; 0 fence;
0 road improvements
Conditions/Comments: JA(A --e'). --(.,,
❑ Utilities: I I I `
N.811 Jefferson
Conditions/Comments:
❑ l I 1 I
Other:
❑ Plan Exam
Fire Prey.
Conditions/Comments:
cocc
Telephone
ToProject Representative
m
n Agencies Performing Special Inspection:
- c 1.
Y O
co lii
it E 2.
V) o
OC
LL
3.
1 indicate above or attach conditions relative to final as built approval
2 indicate above or attach reasons for hold
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North
271 2Moodwa rd Rd. ...............•+ Cv4,,,::
979sE 3 0 lock 1 Sunny Va 1 1 eY AcreW.V.P.•
Acres
1" ' 20' Approx
Irvin Water
P Tupper Inc
NI I;q w FT ., F; - T Job , 8,, /'
6 L l ., hi K:%:1. 4211 -
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