1987, 02-11 Permit App: 87000335 Residence (THIS IS NOT A PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET 11-23.
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 1 Project Number '327
Owner's Name LAST FIRST MI
TUPPER, INC.
Project Address(Street Name&Number) E. 10909 6th Ave Zip
Lot 1 , Block 1 Scarano Addition (Job #1000) Spokane WA 99206
Applicant I Address
Tupper, Inc. _ E. 12929 Sprague
City State Zip Phone
Spokane Washington 99216 (509 ) 928-1991
Business Phone
( 509 ) 928-1991
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 Zip Phone
1 ( I
Contact Business Phone
( 1
Lender Address
City State ( Zip Phone
( )
Res. 00min.
FR
v SubdivlsiontPlat Name/Short Plat Number
. Scarano Addition
Assessor Parcel N umber Portion o f: 21542-1301 Lot ' Block Plat Number
21542-1303, 21542-1301 , & 21542-1103 1 1
Pertinent File Numbers Zone Comp.Plan Census Tract
Number of Dwelling Units Number of Buildings Lot Size(Sq.Ft./Acre) Depth Frontage
1 1
'Front Setback Left Setback Right Setback Rear Setback
Square Footage
Additional Information '
979 main level
932 unfinished basement
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Building Technician DateGroup Type
PLUMBING PERMIT APPLICATION WORKSHEET
t
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
IProject I
Owner's Name Last First MI
Tupper Inc
Project Address(Street Name&Number) E. 10909 6th Ave.
Lot 1 , Block 1 Scarano Addition (Job #1000)
City State Subdivision/Plat Name
Spokane Washington ,Scarano Additi n
Assessors Parcel t Portion of: 21542-1301 , Lot Block Plat I
21542-1302, 21542-1303 and 21542-1103 1 1
Applicant Address
Tupper, Inc. E, 12929 Sprague
City 1 State Zip Phone
Spokane Washington 99216 928-1991
Business Phone
928-1991
Contractor
Address
Tupper. Inc. F, 12929 SpragiP
City State Zip Phone
Spokane I Washington 99216 928-1991
Contact License I Business Phone
Ken or TUPPEIR179DC 928-1991
Describe Work
SFR
Bar Sink(s): Drinking Fountain(s): I Floor Drain(s): Washing Machine(s): /
1
1 (-
DO Wshr(s): Garb D sp(s): • Kit Sink(s): 1 Lndry Tray(s): Sew Eject(s):
urinals) WtrCloset(s): 2 Lav,$): 2 Shower(s): 1 Tub(s): 1 Bidet(s):
h Other: Type;
UJ
Cr
n
X Waste/Grease Interceptor(s):
• •
It Sewer Y ( N ) Septic/Health No.:
UJ 1 Drains-Roof:
� Electric Water Heater(s):
D
Z REPAIR OR ALTERATION: Drainage,Vent,Water Piping/Treatment: Y N
Lawn Sprinkler System(s),Including backflow device on any one meter:
Vacuum breakers or backflow devices in excess of line 16:1-5: (005+:
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, including inspection requirements, will be com-
plied with whether specified herein or not. The granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state of local laws regulating construction or the performance of
construction.
•
SIGNATURE OF . 7 APPLICATION
OWNER OR AGENT 4,&(6 71 • fi--r/e/,. DATE
•
•
DEPARTMENTAL REVIEW
Cond.
ApprovedApproval Hold
Environmental Health Permit Number •
El W. 1101 College
Room 200
iminctiommistfammow
Planning/Zoning
❑ N.721 Jefferson
Permit Number II 8/
Engineers
❑ N.811 Jefferson c
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.
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Owner's Signature •%�� 1�� �1 • _ Date
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ADDRESS East /(';''' 6th Ave. STYLE — 979SE
LEGAL DESCRIPTION L1 61 Scarano Addition
APPLICANT Tupper, Inc. POWER �Modern Electric
05 = 1300 . -P Modern Electric
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