20080218 Permit Pkg 061908City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax:(360)458-3144
Applicant:
Name: Peabody, Betsy
Address: 404 First Street South
Property Information:
Site Address: 404 First Street South
Assessor Parcel No.
Contractor Information:
Name: Builder Pros
Address: PO Box 273
Contractor License No:
Project Information:
Project: Betsy Peabody
Description of Work: Re-Roof
~
Sq. Ft. per floor: (1 st) 0
Heat Type (Electric, Gas, Other):
Fees:
Item
---------------------------
Building Permit - Other
TOTAL FEES:
(2nd) 0
City: Yelm
Subdivision:
Contact:
City: Yelm
Expires:
(3rd) 0
Permit -vo: BLD-08-0218-YL
Issue Date: 06/19/2008
(Work must be started within 180 days)
Receipt No: 54722
Garage 0
Item Fee Base Amt Unit Fee Unit Rate
----------- ----------- ----------- -----------
200.18 0.00 0.00 0.0000
$200.18
Phone:
State: WA Zip 98597
Lot:
Phone: 360-400-3156
State: WA Zip: 98597
Business License:
Basement 0
No. Units Unit Desc
----------- -------------
0.0000 $1,000
ApplicanYs Affadavit:
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,
easements and res ictions of record. If applying as a contractor, i futher certify that I am currently
registered i e St of Washington.
Signature ~~R~' ~~ Date ~p ~~f c~
~
Firm ~ ~ ~~ p~ c.~
# Sets of Prints:
inal Inspection:
Date:
By:
City of Yelm
Community Development Department
Building Division ~ ~~
Phone: (360) 458-8407
Fax: (360) 458-3144 JUN 1 g 20~g
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Permit Fees Schedule
Permit No: BLD-08-0218-YL
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Applicant:
Name: Peabody, Betsy Phone:
Address: 404 First Street South City: Yelm State: WA Zip 98597
Building Permit - Other 032 001-322-10-00 200.18 0.00 0.00 0.0000 0.0000 $1,000
TOTAL FEES: $200.18
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CITY OF YELM
CO ER IA BUILDING PERMIT APPLICATION FORM
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Project Address: ~T ~ir Sf Y~ ~~"~ Parcel #:
Zoning;
Current Use: Proposed Use:
J New Construction ~Re-Model / Re-Roof / Tenant Improvement
^ Plumbing .~ Mechanical ^ Fire PrevenUSuppress/Alarrq
Project Description/Scope of
Project Val
Building Area (sq. ft) Parking Garage 1S` Floor 2"d Floor 3`d Floor
Building Height `/ ~~~L~z ~i~2`(
Are there any environmentally sensitive areas located on the parcel? _
completed environmental checklist must accompany permit application.
If yes, a
BUILDING OW ER/TENANT NAM ~ ~ ' D
ADDRESS ~ ~v~ ~f . S . ~n EMAIL ~
CITY TATE~/~- ZIP y 7TELEPHONE ,7D - ~ --
ARCHITECT/ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR vll~ - TELEPHONE G-3 5
ADDRESS ~ L ~ EMAIL ~vl~ r ' ,/1~.LsT
CITY TATE W ZIP FAX Q - l S
CONTRACTOR'S LICENSE #R~I~f~~~q3~ 5 EXP DATE_CITY LICENSE #~-t-=-~ ' ~
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRfiC i c~R'S LICENSE # EXP DATE CITY LICENSE #
Copy of City Mitigation documentation (TFC).
I hereby c~~ify that the above information is c rect and that the construction on, and the occupancy and the use of the
abo~de c bed property willibe in accorda~e ith the laws, rules and regulations of the State of Washington and the
~ ~ ~q o~
~nt's Signature Date
/ Contractor / 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
105 Yelm Auenue West (360) 458-3835
PO Box 479 (360) 458-3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us