07-0225 Permit Pkg 061407~~pF THEO~~ City of Yelm
~~~~ Community Development Department
V/ ~~ Building Division
Phone: (360) 458-8407
YELM Fax: (360) 458-3144
Applicant:
Name: Borland, David
Address: P.O. Box 2447 City: Yelm
Property Information:
Site Address: 16142 Prairie Creek Loop
Assessor Parcel No. 69240002400 Subdivision: Prairie Creek
Contractor Information
Phone: 458-2808
State: WA Zip 98597
Lot: 24
Name: Applicant Contact: Phone:
Address: City: State: Zip:
Contractor License No: Expires: Business License:
Project Information:
Project: Borland Addition
Description of Work: 640 sf. Addition
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0
Heat Type (Electric, Gas, Other): OTHER
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Building Permit -Other 321.25 0.00 ~ 0.00 0.0000 0.0000 51,000
Building Plan Review 208.81 0.00 0.00 0.0000 0.0000
TOTAL FEES: E530.06
Applicant's 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 restrictions of record. If applying as a contractor, I futher certify that I am currently
registered i the State of Washington.
Signature B Date ~~
~~ - d~
Firm
permit No: BLD-07-0225-YL
Issue Date: 06/14/2007
(Work must be started within 180 days)
Receipt No: 48930
# Sets of Prints:
Final Inspection:
Date:
RECEIVED
CITY OF
YELM
P,0 Uox 479
Yelm, WA 913597
360-453-3244
RECEIPT No. ~ f ~ y ;'
:. , ,, , ,
~;~
RECEIVED FROM '
DATE REC. N0.
~;,-, r .. ~ ,, ~ AMOUNT
.~. -
REF. N0 ~ }
J
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Applicant:
Name: Borland, David
Address: P.O. Box 2447
Project Information:
Project: Borland Addition
Description of Work: 640 sf. Addition
Site Address: 16142 Prairie Creek Loop
Permit Fees Schedule
Permit No: BLD-07-0225-YL
Phone: 458-2808
City: Yelm State: WA Zip 98597
Assessor Parcel No. 69240002400
Fees:
Item Acct Code
------------ Item Fee
----- Base Amt Unit Fee Unit Rate No. Units Unit Desc
Building Permit -Other
032 001-322-10-00 ------
321.25 ---------
0.00 -----------
0.00 --------
0.0000 -------- -----------
0.0000 $1,000
Building Pian Review 100 001-345-83-00 208.81 0.00 0.00 0.0000 0.0000
TOTAL FEES: 5530.06
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{---~ R-10 Insulation. 6 Mil Vapor
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NOTES:
1. Place anchor bolts no closer then 4" or 12 "
from the end of the sill plate.
2. Washers shall be 3x3x5/16
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CITY OF YELM
Rr-~pENTIAL BUILDING PERMIT APPLICATION FORM
(.-. ~ ~.r
~ ~ IS ~'1~ Parcel #: '
`1 vS ~ c t ~~ ~ Q~ ~~ ~j
Project Address: ~ 1, } ~ ~ f-QS I~~P~t l-l G
~,;~ , ~ re <~. K Lot #:~~ Zoning;
Subdivision: r ~ ~ tlon Sign
u Home Occupy
,~ New Construction ~ Re-Model ! Re-Roof /Addition
u Plumbing u Mechan'~cal a Mobile /Manufactured Home Placement u Other
Project DescriptionlScope of Work: c"~
s O G ~ c~ '~
Project Value:
2"O Floor Garage ~k----
Buitding Area (sq. ft) 1'~ Floor
Basement Carport -Patio
# Bedrooms- # Bathrooms~• S Heati GA TNER or ELECTRIC (Circle One)
~~.? If yes, a
Are there any environmentally sensitive areas locaned mltit applicat on.
completed environmental checklist must accompa Y Pe
Lei'
Copy of mitigation agreement with Yelm Community Schools, if applicable.
I hereby certify that the abo ill be n a~cordanc wa kht the lawst ru{ss and reg~atlons o< tM Stat~of Washingtoe at~d the
above dsscrtbed pmP~Y
Cky of Yelm.
Date
A licant's Signature
. ner Contractor /Owner's Agent /Contractor's Agent (Please circle one.)
All permits are non-transferable and will expire if work authonzed 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 Wet (360) 458.3144 FAX
PO llox 479 ruww.ei.yelne.ma.ux
Yel-n, WA 98597
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