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20190019 CL 9 ApplicationCITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM Project Address: 15419 Coles Ct SE Subdivision: Parcel #: Coles Landing Lot #: 9 Plan #: 2470 , Zoning: / New Construction F1 Re -Model / Re -Roof /Addition 0 Home Occupation Sign El Plumbing El Mechanical El Mobile /Manufactured Home Placement 11 Other Project Description/Scope of Work: Construct SFR Project Value:-- $125,000 Building Area (sq. ft) Vt Floor 1103. 2nd Floor 1369 3rd Floor Garage -2 car 400 1 3 car Covered Patio Covered Porch ioo Patio 100 Deck Bedrooms # Bathrooms2.5 Heating (FOTHER or ELECTRIC (Circle One) Are there any environmentally sensitive areas located on the parcel? No ff yes, a completed environmental checklist must accompany permit application. :Mountain Ierrace 131131ders ADDRESS?10 Mosman Ave. ,SE EMAIL MTBuurcbasRngagmaol.com__ CITY STATE WA ZIP TELEPHONE -Yelm 59Z :16o 4r;8 1509 LICENSE # ADDRESS 1202 Main St Ste 104 EMAIL CITY. Sumner STATE—WA ZIP 9,93,90 TELEPHONE A L`:c.�:1►:N:•. TELEPHONE ADDRESS -EMAIL CITY STATE -ZIP FAX CONTRACTOR'S LICENSE #_MQ_U=890BS_ EXP DATE3L11CITY LICENSE #-603 2Unra2 J PI TELEPHONE 253 .405.2499 ADDRESS 17909 Kismet Lane SE EMAIL CITY Yelm STATE WA ZIP 98597 FAX CONTRACTOR'S LICENSE # JRSPLI*975D5 EXP DATE3/19 CITY LICENSE # 602.264.092 Pr i emeGn fin ELEPHONE 253.536.3357 ADDRESS 1201 E Yelm Ave STE 400 EMAIL CITY Yelm STATE WA ZIP 98597 FAX CONTRACTOR'S LICENSE # PREMIGC884RJ EXP DATB2/18CITY LICENSE # 603.257.522 , Copy of mitigation agreement with Yelm Community Schools, if applicable. I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above described property will be in accordance with the laws, rules and regulations of the State of Washington and the City f Yelm-j I�A A "I Ywpt'sature Date SiTn ner / Contractor / Owner's Agent / Contractor's Agent (Please circle one.) All permits are non -transferable and will expire if work authorized by such permit is not begun within 180 days of issuance, or if work is suspended or abandoned for a period of 180 days 105 Yelm Avenue West (360) 458-3835 Yelyn, WA 98597 (360) 458-3144 FAX www.ci.yelin.wa.us