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20090252 Permit Pkg 122809City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Permit Ivo.: 20090252 Issue Date: 12/28/2009 (Work must be started within 180 days) Applicant: Name: ROSSI CAPITAL Address: 6524 CROMWELL BEACH DRIVE NW GIG HARBOR WA 98335 Property Information: Site Address: 1 dA7R 1(11 ST WdY SF 77 Phone: 360-239-0146 Owner: ROSSI CAPITOL Assessor Parcel No.: 81780002200 Subdivision: Contractor Information: Name: ROSSI CAPITAL Address: GLEN 2360 ALLEN RD SE OLYMPIA WA 98501 Contractor License No.: ROSSICL945DZ VINTAGE GREENS Lot: 22 Phone: Expires: 3/26/2010 Project Information: Project: NEW RESIDENTIAL BUILDING Description of Work: SFR PLAN 9933-B LOT 22 Sq. Ft. per floor: First 1453 Heat Type (Electric, Gas, Other): GAS Second Third Garage Basement Fees: Item NEW RESIDENTIAL BUILDING MECHANICAL PLUMBING 537 Contractor Fees ROSSI CAPITAL $12,648.62 BEST CHOICE HEATING $ 78.25 JR'S PLUMBING $ 118.00 TOTAL FEES: $ 12,844.87 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, easements and restrictions of record. If a I ing as a contractor, I further certify that I am currently registered in the State of Was C,~ OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: BY ~~ta ~~ ~~LI(~ I'`I ~~ I Ii`ji r r-•_r.; i'I t':f1 ; :rj ij "I+:.I ~ i' •~ (.{' r.,...ra., r-~?Q ~~`,...;: .1"7 (~ii!!'i~~ L?i ~T:l T':T~jC: 't:: I.:Sy T~-f' „.ijtj~alti::.: )t_ .d.91-!~-+~'R :, fi (`;_:~°'.. r;~ r.r+'r my ~-,r,. h,~ I -; i fl ;, _1.~ .,;: ! L.:: i alb". -.. i± i ~ .mow!.!. ~..;'~ K 3-i ~~•I, f; f I.T!,.:! , I1'~li!i I''al I:• ~i~cl~'-. ..i...i; !~F~1.1 ... ~' ~SZ_ CITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM Project Address: %~`% ~L.' !OI s i~f SE:r Parcel #: ~ f ~t FjC~c~~ `ZZ~'~ Subdivision: t:J yew Lot #:_~;~~ Plan #:~,~ Zoning: flew Construction ^ Re-Model / Re-Roof /Addition ^ Home Occupation Sign ^ Plumbing ^ Mechanical /n~ ^ Mobile / Manufacture11d Home Placement ^ Other Project Description/Scope of Work: 1~ ~~:~'~~;~C Ll c ~.,,~, ~ PC Project Value: ~~ ~7 C~ `'~`' Building Area (sq. ft) 13` Floor 2"d Floor Garage Deck .3~~ Basement Carport Patio # Bedrooms # Bathrooms,L Heati :GAS/1 THER or ELECTRIC (Circle One) Are there any environmentally sensitive areas located on the parcel?-~ /f yes, a completed environmental checklist must accompany permit application. BUILDING OWNER NAME: ~ fiA ~ ADDRES}~J?,moo /~C~ ~e"~ EMAIL CITY C~[C~~,~rka STATEl~e1 ZIP `~3/ TELEPHONE 3~0 23S (J/~f~o r ARCHITECT/ENGINEER LICENSE # ADDRESS EMAIL CITY STATE ZIP TELEPHONE GENERAL CONTRACTOR i (.R + (.- TELEPHONE~C~Ci ~~.3'`7 l~` ADDRESS ~ " } ft'i''1 EMAIL CITY© w tib- STAT~ZIP_ ~~~/ _FAX CONTRA T R'S LICENSE # . C L-"~XP DATE CITY LICENSE # PLUMBING CONTRACTOR b ~;,>1 ~ TELEPHONE 3 yL' Z`f~`,~ ADDRESS ~ EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # MECHANICAL CONTRACTOR ~ % ~ ~ _ ' ' TELEPHONE 2~ ,a~5~~-' / :; ADDRESS r ~' ~S ~' ~ vt EMAIL CITY Z~.c:~.~c1 STATE~_ZIP ~ FAX CONTRACTOR'S LICENSE # - CGN -~AT CITY LICENSE # 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 of Yelm. Applicant's Signature Date Owner /Contractor /Owner's Agent /Contractor's Agent (Please circle one.) All permits are non-transferable and wi i expire if work authorized by such permit is not begun within 180 days of~ ,~ ' suspended or abandoned for a period of 180 days ~E 2 ~ 20~J 105 Yelm Avenue West ,~ (360) 458-3835 Yelm, WA 98597 ~ ~' o Z ~ `~ ~ 3 ~ (360) 458-3144 FAX www.ci.yelm.wa.us ~~~ P~~ ° Y%~~~~ 9~ ~~s~ G ~f ~~ ~~~~~/~Soo~aaoo ~~~i G~-5 ._- P 6~h~~- ~~~ o ~,, ~~ ._~ ~~7 ~lw ~2~~') -lI ~- 4' ~~ ~~-~ i ,~ ~r 5Co' ~'~ .'~11. ~ /!~`~ ~ ri L ~~~ C ~ ~ yam, ~~~`~ ~~'~_~ ~ = ~..~ E C ~ n °~._ ~ ., 20~~ ., ~~ ~f ~ . _ ,.. _. W_~.~~ rEtM c~;~rr~u~zTV st;~traLs PG BC~K 476 YE[M WA 9597 ~' ~,""r ~ ~ Gerber Te rni i na l ; ~ ~~ec~ipt; ?1~GOG t"~al"U~~11 ~;ece~ i pt ; 'tll\rJ:iJ t`If:IJ;>S 1 ~,~r,7 C~!~ita1 ~ ~~. ~~e~s3 t ?1~8i:1~7 ~G 1C:C;~=f ~ahi ~~tv., item rice i I;F'f RkV tJC!1 MTllGraT~ON 214C~,GC Terra 1Ja I ley - i of '~~ tb'intage Green} ~:,~;btatal: r r' iax: 114.E G~ fiotal; G.CG 214G.CG C,r~ecr, ~ 14G , Cv 56~( ~~r?arige DtJe; U,GG TH~tti~. Yt7u