20090208 Permit Pkg 102209City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Applicant:
Name: JAMES LEVIS
Address: 2110-3 52 AVE NW
OLYMPIA WA 98502
Property Information:
site Address: 301 1ST ST N
Assessor Parcel No.:
Contractor Information:
Name: JAMES LEVIS
Address: JAMES LEVIS
2110-3 52 AVE NW
OLYMPIA WA 98502
Contractor License No.:
Phone: 360-866-9795
Owner: JAMES LEVIS
Subdivision: Lot:
Phone:
Expires: 0/00/0000
Project Information:
Project: RE-ROOF AND ENTRY
Description of Work: RE-ROOF STORAGE UNITS BUILDING AND RE-BUILD ENTRY ROOF TO OFFICE
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
BUILDING JAMES LEVIS $ 97.25
TOTAL FEES: $ 97.25
Applicant's Affidavit:
I certify that I have read and examined the information contained within the application and know the same
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regulations including those governing zoning and land subdivision, and in addition, all covenants,
ea nts and restrictions o cord. If applying as a contractor, I further certify that I am currently
registere he State of Wash ton. ~ J
Siq„~.t~;e--- ~ Date ~ d / Z3l J
Firm
Permit No.: 20090208
Issue Date: 10/22/2009
(Work must be started within 180 days)
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CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
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Project Address: 3 D f 1~ ! f l S 1 Parcel #:
0
Zoning; Current Use: Proposed Use:
!- New Construction ~Re-Model / Re-Roof /Tenant Improvement
Plumbing -; Mechanical -Fire Prevent/Suppress/Alarm ~- Other
Project Description/Scope of Work: ~~ u a ~ ~r..u. w~l ~~tLC
Project Value: ~s/~~ %~ ~'. JC~,e,~~ (~2~-~'ua~) ~~~S~C~c~ C~ 7~~/`~9-/
Building Area (sq. ft) Parking Garage 1 sc Floor 2"d Floor 3`d Floor
Building Height ~Z ~X~'`~
Are there any environmentally sensitive areas located on the parcel? ~~~ If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNERlTENANT NAME: qyn..~. vu
ADDRESS 1 ~ - W EMAIL w ~ t I `j(,~ ~ wtt N . La'l~.
CITY G~ STATE w~ ZIP f+1 TELEPHONE~4,o :(.in 97S ~'
~~~~~~ ~~
ARCHITECT/ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LiGENSE #__ EXP DATE CIT1` LICENSE # e _
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DA~i-E CITY LICENSE #
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
Copy of City Mitigation documentation (TFC).
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 ' accordance with the laws, rules and regulations of the State of Washington and the
City of YeIrA
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Applicant's~ygna re Dat
Owner / Contrac~6f /Owner's Agent /Contractor's Agent /Tenant (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
eciv
105 Yelm Avenue West (360) 458-3835
PO Box 479 (360) 458-3144 FAX
Yelm, WA 98597 www.ei.yelm.wa.us
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