20040081 Pl Permit file 062804City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Permit rvo: PL-04-0081-YL
Issue Date: 06!28/2004
(Work must be started within 180 days)
Receipt No: 32145
Name: Southwest Services Phone: 491-7302
Address: 1210 franz St. City: Lacey State: WA Zip
Property Information:
Site Address: 510 Yelm Ave. W
Assessor Parcel No. 21724141202 Subdivision: NIA Lot: NIA
Contractor Information:
Name: Applicant Contact: Phone:
Address: City: State: Zip:
Contractor License No: SOUTHS1042n2 Expires: 05101105121 Business License:
Project Information:
Project: Yelm Nail Spa
Description of Work: Install waste lines for lav and nail sinks
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
---------------------------
Plumbing Permit 41.00 20.00 21.00 7.0000 3.0000 Fixture
TOTAL FEES: 541.00
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 in the State of Washington.
Date
Firm
t Sets of Prints:
final Inspection:
Date:
By:
l00'd 14101
of ~ City of Yelm / Per it Fees Schedule
o~' ~~
a Community Developm®nt DE~partment ~q'D Pe mit No' PL-04-0081-YL
a
Budding bivision
Pnpne: (ago) ass-s4o7 i .JUN 2 5 200
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YEL Fax: (360) 458-3144 ~
%CITY OF YELM
Applicant:
Name: Southwest Services / J I ~ ~ Phone: 491-7302
i Lace /~ / Sta e: WA Zip 98503
Address 1210 franz 3t tY Y
Proj®ct Information:
Project:Yelm Nail Spa
Description of Work: Install waste lines for lav and nail sinks
Sile Address: 510 Yelm Ave. W Assessor Parcel No. 21724141202
Fees:
f~em ACCt Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Plumbing Permit 032 _~ X1.00 20.00 21.00 7.0000 3.0000 Fixture
001-322-10.00
TO1AL FEES: 541 00
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y`~~,f,HtF~;,~ CITY OF
T YEIJM
P.O. Box 479
Yelm, WA 98597
yg1,~ 360-458-8403
RECEIVED wk.•pOkm'?` ;ENE G~)LLPR(. & 0H CENTS
RECEIVED FROM DATE REC. N0.
;;CU?`1?;dEUT S;,'F.VICG'.S 05/25!04 32145
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RECEIPT
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LICENSE DETAIL INFORMATION Form Page 1 of 2
STATE OF WASHINGTON
DEPARTMENT OF LABOR AND INDUSTRIES
Specialty Compliance Services Division
P. O. Box 44000 Olympia, WA 98504-4000
TI-IE RESULT OF YOUR INQUIRY FOR LICENSE NUMBER SELECTED IS:
LICENSE DETAIL INFORMATION
Current Filter: None
Registration# or License SOUTHS1042N2
Name SOUTHWEST SERVICES INC
Address 1210 FRANZ ST
Address
City LAC EY
State WA
Zip 98503
Phone Number 3604917302
Effective Date 8/22/1996
Expiration Date 5/1/2005
Registration Status ACTIVE
Type CONSTRUCTION CONTRACTOR
Entity CORPORATION
Specialty Code PLUMBING
Other Specialties UNUSED
UBI Number 600238570
* * *VIEW CROSSR_EFERENCE FILE_FOR THIS LICENSE*_*
* * *VIEW PRINCIPAL OWNER~S~_FOR THIS LICENSE*
* * *VIEW CONTRACTOR BOND/SAVINGS INFORMATION
* * *CHECK INQUIRY. FOR SUMMONS AND COMPLAINTS*'` "
* * *VIEW CONTRACTOR INSURANCE_INFORMATION '` "
New inquiry by CITY , NAM[; , PRINCIPAL OWNER NAME , LICF;NS~%, UI3I
NtiMBER ,check the
L_&I C__o_ ntractor Industrial Insur~;nec Premium_Status or return to the L&I Construction
Complian_c__e Home Page
hops://wws2.wa.gov/Ini/bbip/TF2Form.asp?license=SOUTHSI042N2 6/I 8/2004
~~ N~ ~
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM ~~// ~/
Project Address: S ~ ~ ~ ~ ~^ ~~ Parcel ~: ~ ~ ~~ -l`l / ~~-
Zoning; Current Use: Proposed Use:
^ Ne~v Construction ^ Re-Model / Re-Roof /Tenant Improvement
Plumbing ^ Mechanical ^ Fire Prevent/Suppress/Alarm ^ ~Ot"her
Project Description/Scope of Work: ~ °~ ~e ~ +- Vy ~a-S~re- -~ o ~- la _ l./~U • , ~v ~'i~t~!-~/~ .
Building Area (sq. ft) Parking Garage 1~' Floor x 2nd Floor 3rd Floor
Building Height
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
I hereby certity 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.
Appli nt's Signature Date
Owner /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
C'Cammunitq ncvcl~rrmcnt',Punnti.c !'mc~ilures'ISuilding i'crmiL•::(~~munl31clg1'cnnit~\pp,Jnc I',i~;c 2 i~f d
Copy of City Mitigation documentation (TFC).