20050293 Permit Pkg 092105~~ f T"Fpp~ City of Yelm
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Property Information:
Site Address: 15131 Carter Loop SE
Assessor Parcel No. 52920002700
~ ,p Community Development Department
o. ~n
Building Division
Phone: (360) 458-8407
ELM Fax: (360) 458-3144
Applicant:
Name: Groldschmidt, Graryna
Address: 15131 Carter Lp. SE City: Yelm
Contractor Information:
Name: Appliant
Address:
Contractor License No:
Subdivision: Hawks Landing
Contact:
City:
Expires:
Project Information:
Project: Goldschmidt Deck
Description of Work: Deck addition
Sq. Ft. perfloor: (1st) 0 (2nd) 0
Heat Type (Electric, Gas, Other):
(3rd) 0 Garage 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate
Building Permit -Other 83.25 0.00 0.00 0.0000
TOTAL FEES: $83.25
Phone: 458-5785
State: WA Zip 98597
Lot: 27
Phone:
State: Zip:
Business License:
Basement 0
No. Units Unit Desc
0.0000 $1,000
Applicant's Affidavit:
~FFICIAL USE ONL~
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:
~ Date:
Signature G. ~ ~ Date ~,~ ~,'~
By:
Firm
Permit No: BLD-05-0293-YL
Issue Date: 09/21/2005
(Work must be started within 180 days)
Receipt No: 38301
CITY OF
YELM
P.o. sox a7s
Yelm, WA 98597
360-458-8403
RECEIVED FROM DATE REC. NO.
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RECEIPT No. 3 8 3 01
AMOUNT REF. NO.
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