20100009 Permit Pkg 012010
City of Yelm
Community Development Department
Bwldmg Drviston
Phone (360)458-8407
Fax (360)458-3144
Applicant
Name ROSEMONTRETIREMENT
Address 215 KILLION RD
YELM WA 98597
Propertylnformatton
Site Address 215 KILLION RD NW
Assessor Parcel No 21724120404 Subdivision N/A
Contractor Informatton
Name ROSEMONT RETIREMENT
Address
215 KILLION RD
YELM WA 98597
Contractor License No
Phone
Expires 0/00/0000
Protect Information
Protect LAND SITE PLAN REVIEW
Descnption of Work PERMIT EXISTING SALON SPACE 15 FT X 15 FT FOR USE
Sq Ft per floor Ftrst Heat Type (Electnc, Gas, Other)
Second
Third
Garage
Basement
Fees
I[em
SITE
Contractor Fees
ROSEMONT RETIREMENT $ 350 00
TOTAL FEES $ 350 00
- AMOUNT PAID $ 0 00
BALANCE DUE $ 350 00
Applicant's Affidavit
I certfy 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 m addition, all covenants,
easements and reslnchons of record If applying as a contractor, 1 further certify that I am currently
registered in the State of Washington
Signature ~ Date
Firm
Permlt No 20100009
Issue Date 1120/2010
(Work must be started within 180 days)
Phone 503-588-3505
Owner MWSH YELM LLC
Lot
OFFICIAL USE ONLY
# Sets of Prints
Final Inspection
Date
By
City of Y~l~
c j; ~G! 45fl-8402
kEC#: 0701"07v i/°v""/2010 12:34 P~1
Of'ER: CC TERM: U01
kEEq: ;183
TRRtl: 33.QOOn HUILGIRu PERi~I?8
k85E~nGT RETIREi~EN?
215 KiLLIf)n" RG 77(~
SITE 3,O,r,~OrF
TEttGEkED: =50.r~0 ChEGK
NFBLIEr,: 3F0.00-
--------------
CHnP7GE: 0.00