20040116 Permit Pkg 081304City of Yelm
SE-04-0116-YL Details Permit Management
~ File ID ~-~ Address ~ ~~ ~~~~~1 ` Project Name / Description Appl. Date Case1D: ~~
SE-04-0116-YL 102 Yelm Avenue East
Sec: Twn: Rnge
Zoning:
Assessor/D: 99002045427
Received8y: RA
Contacf -nformation:
AppliCant.' Drew Harvey Theater
Owner: Steve craig
Engineer/Architect:
Surveyor.
Drew Harvey Theater Sidewalk8/5/04 172
August 13, 14, 15, 2004 Sidewalk Sale for Drew
Harvey Theater,
50(c) 3 Non-Profit Organization
ProjectValue: S o
StBtUS: APPROVE
General Contractor.•
Mechanical Contractor.
Plumbing Contractor:
Fees:
Item Tot Amt
--------- Base Amt
-------- Var Amt
-------- Var Qty Var Rate Comments
-------- ---------- --------
--------------------
Building Permit - Ot ---
$0.00 50.00 $0.00
Total Fees $0.00
AmtPaid: So.oo DatePaid: 08/05/2004 Receipt#: n/a FeeStatus: Paid
Workflow:
Item Status Due Date
-- Complete
-------- Sign-Off By
-------------------------
----------------------
Application Received --- --------
Complete ------
08/06/04 08/OS/09 n/a
Application Approved Complete 12/04/04 08/OS/09 Roberta Allen
Activity Log: '
Action Loq Date Message
-------- -------- --------------------------------------------------
NEW OB/OS/09 RA Received application. File ID 'SE-04-0116-YL', Case# = 172
FEES 08/OS/04 Fees frozen with total due of $0.00
FeesPaid 08/OS/04 Fees paid in the amount of $0.00
SIGNOFF 08/OS/09 Item 'Application Approved' sign-off by Roberta Allen on 08/OS/04
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Report Produced By Permits Dashboar m)
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v
Thursday, August 05, 2004
Page 1
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C1TY OF YELM ~/ V~~
ERMIT APPLICATION FORM Q~G p 5~~~4
Project Address:~d ~ ~E~-1~l ~lt ~ Parcel #: ~ ~(_~~-~a ~ ~o~ ~
Subdivision: Lot ~: Zoning;
^ New Construction ^ Re-Model / Re-Roof / Addition ^ Home Occupation Sign
C~ Piumbing ^ Mechanicai ^ Mobile / Manufactured Home Placement ^ Other
Project DescriptioNScope of Work: ~~ n~ i,c~~LiC ~'~~.
Project Value:
Buiiding Area (sq. fit) 1St Fioor 2~d Floor Garage Deck
Basement Carport Patio
# Bedrooms_ # Bathrooms_ Heating: GAS/OTHER or ELECTRIC (Circie One)
Are there any environmentally sensitive areas located on the parcei? If yes, a
completed environmental checklist must accompany permit application.
~
/~
BUILDING0INNER;NAME: ~~'vC n~'1~<<-„
ADDRESS
CITY STATE ZIP TELEPHONE
R ~+ F~'.i.~ ' ICENSE# -~•i3,~4~~1~'
..
ADDRESS ~ . ~ .~ ~iC.C ) ~ 1~9Q !.S P20~(.
CITY STATE ZIP TELEPHONE ~(~n--4S~'-g~~
GENERAL"CONTRACTOR TELEPHONE
ADDRESS
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
PLUMBING CONTRACTOR TELEPHONE
_... _ _..
ADDRESS
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS
CITY STATE ZIP FAX
CONTFiACTOR'S LICENSE ~ EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schoofs, 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 wiii be in accordance with the laws, rules and regulations of the State of
Washington and the City of Yelm.
~ ~
Applicant's Sig a Date
Owner / Contrac r/ Owner' gent / Contractor's Agent (Ptease circle one.)
All permits are non-transferable and U~ill expire if work authorized by such permit is not
begun within 1 SO days of issuance, or if work is suspended or abandoned for a period of
1 SO days
C'.:~C~~mmunity DcF'clopmcnt'(~orms & Proccdures113uilding Pcrrnit~',Ilcr.Rld ~1'crmit;A~,p.clu~;
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