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20090256 Permit Pkg 123009City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360)458-3144 Applicant: Name: LEGENDS Address: PO BOX 734249 PUYALLUP WA 98373 Property Information: Site Address: 18117 VONC:II 1 P SF Assessor Parcel No.: 69270001300 Subdivision: Contractor Information: Name: LEGENDS Address: PO BOX 731249 PUYALLUP WA 98373 Contractor License No.: LEGENRC984DN Project Information: Project: ROOF Description of Work: RE-ROOF REPLACE SHINGLE ROOF VALUE: $4,975.00 Expires: Sq. Ft. per floor: First Heat Type (Electric, Ga: Second Third Garage Basement Fees: Item Contractor BUILDING LEGENDS ROOF LEGENDS Permit No.: 20090256 Issue Date: 12/30/2009 (Work must be started within 180 days) Phone: 253-548-3197 Owner: PATRICIA SMITH Phone: 253-548-3197 12/31 /2010 TOTAL FEES: 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 applying as a contractor, I further certify that I am currently registered in the State of Washington. Signature Date ~~3 ~~~ Firm Lot: Fees $ 25.00 $ 0.00 $ 25.00 OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: ey: ~ifi~~ ~f Y~ll~ {:~ryF, Qn~~F+i i (~i I;:I1~1'`II~i~Ll~t}~j 1C';4i (~~" ~~'c.~'4 CO T~~~= ~;til k~f~: ~~'~fil It~f~~a .^,.1. ~~fi,+~ ll ~ll_.~J. ~~E! C+Ll1{'I11u ~ EGE~!~1S ?~+i'7 1;~~1j~Ti ~~+r•~ 1T~5'3 ! x.11 t ~~ ,7~ L'L~L~ G.JaS!~~~E i r a ~~`' , I~i~ li_IEn. r)r ryni t.la :t.! t 11 (~ F i3fi IJ:1 [il~j"~ u tea ~l;! ~9va-~~ CITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM Project Address: (0117 yQvtU~ ~p~L= Parcel Subdivision: Lot #: Plan #: Zoning: ' New Construction ~ Re-M Plumbing Mechanical Project Description/Scope of Work:_ Project Value: Building Area (sq. ft) 1St Floor Basement- # Bedrooms- # Bathrooms. odel Re-R /Addition Home Occupation Sign Mobile /Manufactured Home Placement Other ~..Q\ac~ X1.1; w~, l e ~~ ~ ~ ~ZS-.o~ _ 2"d Floor Garage Deck Carport Patio Heating: GAS/OTHER or ELECTRIC (Circle One) Are there any environmentally sensitive areas located on the parcel? /fyes, a completed environmental checklist must accompany permit application. BUILDING OWNER NAME r: c: +9 w~'F~'~ ADDRESS b4'7 Q Gc1 ~' EMAIL •+' '1-S i'l"~ ~° Ctlvl.tcas~-, I~ ~'~ CITY `~~~rn STATE ZlPplgSzYl TELEPHO E ZS~-- ~-1'10- ~ZS'3 ARCHITECT/ENGINEER LICENSE # ADDRESS EMAIL CITY STATE ZIP TELEPHONE GENERAL CONTRACTOR~L.~,2~lc~s TELEPHONE -~ 31G ADDR SS P© © "13't Z4 EMAIL CITY ~ STATE7~1~ 01 FAX Zb ~ S`f 'S'ki CONTRA TOR'S LICENSE # lc fay P DATE CITY LICENSE # 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 CONTRACTOR'S LICENSE # EXP DATE 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 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 '! 80 days 105 Yelm Avenue West (360) 458-3835 Yelm, WA 98597 DEC 2 ~ 2009 (360) 458-3144 FAX wwm.ci.yelm.wa.us