07-0229 Permit Pkg 061407~oF THfp City of Yelm
9
0
Contractor Information:
Name: Bell and Bell Contact:
Address: P.O. Box 99 City:
Contractor License No: BELL68958PM Expires: 10/14/07287
~ Community Development Department
4
Building Division
Phone: (360) 458-8407
YEL Fax: (360) 458-3144
Applicant:
Name: Cummings, Floyd
Address: P.O. Box 24 City: Yelm
Property Information:
Site Address: 614 Crystal Springs Rd
Assessor Parcel No. 22719240200 Subdivisi n:
Project Information:
Project: Cummings Garage Door
Description of Work: Install Garage Door
Use 4x10 Header Min.
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other)' OTHER
Fees:
Item Item Fee Base Amt Unit Fee
Building Permit -Other 83.25 0.00 0.00
TOTAL FEES: 583.25
Permit No: BLD-07-0229-YL
Issue Date: 06/14/2007
(Work must be started within 180 days)
Receipt No: 48923
Phone: 458-5354
State: WA Zip 98597
Lot:
Phone: 446-7739
State: Zip:
Business License:
Garage 0 Basement 0
Unit Rate No. Units Unit Desc
0.0000 0.0000 51,000
Applicant's Affadavit:
OFFICIAL USE ONLY
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 # Sets of Prints:
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. Final Inspection:
Si natures -' Date Date:
Firm By'
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: ~ ~ /./ C ~YS ~ a ~ S V R I) Parcel #:
Subdivision: Lot #: Zoning; f~ ~S, uCv , 4 ~
U New Construction u Re-Model / Re-Roof /Addition u Home Occupation Sign
U Plumbing u Mechanical a Mobile /Manufactured Home Placement u Other
Project DescriptioNScope of Work: 1 X s ; ~,,~. c n,1:, c ~ t~ ~, ~~ ,~
Project Value: `~, ', 'C
Building Area (sq. ft) 1~' Floor 2nd Floor Garage Deck
Basement Carport Patio
# Bedrooms- # Bathrooms- Heating: GAS/OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? ~v o If yes, a
completed environmental checklist must accompany permit application.
RECEIVEQ
JUN l 1 2W~
BUILDING OWNER NAME:J'= +~oy n ~n , c_ „ „~ ,,, , N ~_ ;
ADDRESS__i~~~~ . x3 ~~ x ~_ -~ EMAIL
CITY ~ V ~..~ STATE w -~ ZIP `I ~ s9 ~ TELEPHONE- ~'G c ., ~y.,- ~.. ti-.? ~ N
PLUMBING 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 certHy that the above IrHormatlon 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 180 days
]OS Yelm Auenue Weat (360) 458-3835
PO Bor 479
Yelm, WA 98597 (360) 458~?144 FAX
rueuro.ci.yelm.wa. ue
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General/Specialty Contractor
A business registered as a construction contractor with L&I to perform construction work within the scope
of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment
of account and carry general liability insurance.
license Information
License BELL686958PM
Licensee Name BELL 8 BELL BLDRS >i OH DRS INC
Licensee Type CONSTRUCTION CONTRACTOR
UBI 602511400 Verify Workers Comp Premium
Status
Ind. Ins. Account
Id
Business Type CORPORATION
Address 1 PO BOX 99
Address 2
City RAINIER
County THURSTON
State WA
Zip 98576
Phone 3604467739
Status ACTIVE
Specialty 1 GENERAL
Specialty 2 UNUSED
Effective Date 10/14/2005
Expiration Date 10/14/2007
Suspend Date
Separation Date
Parent Company
Previous License BELL660111 MR
Next License
Associated
License
Business Owner Information
Name Role Effective Date Expiration Date
BELL, TIM PRESIDENT 10/14/2005
Bond Information
No Matching Information
vings Information
https://fortress.wa.gov/Ini/bbip/Detail.aspx?License=BELLBBB958PM 6/12/2007
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Bank
Bank Branch Assignment of Savings Effective Release Assignment Impaired Received
Savings Name Location Number Date Date Type Date Amount Date
Until
b1 KEYBANK YELM 1504318431846203/471 10/07/2005 Released Bond $12,000.00 10/14/2005
Insurance Information
Company Effective Expiration Cancel Impaired Received
Insurance Name Policy Number Date Date Date Date Amount Date
FIRST
SPECIALTY
!/1 INS CORP FCP229002916802 10/22/2004 10/22/2007 $1,000,000.00 10/20/2006
Summons /Complaints Information
No Matching Information
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.w.~ i Access Agreement ~ Privacy and securlt.y statement ~ intended usplexterna€ cauent policy I SiaH only link Visii it cess. ~n z.onv
https://fortress.wa.gov/lni/bbip/Detail.aspx?License=BELLBBB958PM 6/12/2007