07-0348 Permit Pkg 091807City of Yelm
Community Development Department
Building Division
Phone: (360)458-8407
Fax: (360) 458-3144
Applicant:
Name: Range
Address: 210 SE McKenzie
Site Address: 210 SE Mckenzie Ct
Assessor Parcel No. 82800000100
Contractor Information:
Name: Applicant
Address:
Contractor License No:
Project Information:
Project: Range Reroof
Description of Work: Tearoff and reroof
Sq. Ft. per floor: (1st) 0 (2nd) 0
Heat Type (Electric, Gas, Other): OTHER
Fees:
Item Item Fee
Building Permit -Other 25.00
TOTAL FEES: $25.00
Applicant's Affadavit:
Permit ivo: BLD-07-0348-YL
Issue Date: 09/18/2007
(Work must be started within 180 days)
Receipt No: 50329
City: Yelm
Phone:
State: WA Zip 98597
Subdivision:
Contact:
City:
Expires:
(3rd) 0 Garage 0
Base Amt Unit Fee Unit Rate
0.00 0.00 0.0000
Lot:
Phone:
State: Zip:
Business License:
Basement 0
No. Units Unit Desc
0.0000 $1,000
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, restrictions of record. If applying as a contractor, I futher certify that I am currently
registered i the fate of Washington. Final Inspection:
~ Date:
Signature ~~ ~~~,,,,-~ Date ~~', ~ ~ -
By:
Firm
~~uF rrtE p ~ City of Yelm
.,,''m Community Development Department
~ ~~I
.; Building Division ~~,~ ~ 7 ~~n7
Phone: (360) 458-8407
.~.
YELM Fax: (360) 458-3144 CITY OF YELM
Applicant:
Name: Range
Address: 210 SE McKenzie City: Yelm
Project Information:
Project: Range Reroof
Description of Work: Tearoff and reroof
Site Address: 210 SE Mckenzie
Fees:
Item Acct Code
Building Permit -Other 032 001-322-10-00
TOTAL FEES:
I~~,°` T"`~9"~~~ CITY OF
T YELM
~ P C. Box 4i9
'r'ein. 6VA 9859%
i' 3E0-s58-32~d
RECEIVEC; ****TWENTY FIVE DOLLARS & 00 CENTS
RECEIPT No. ~~ :~" ~ ~ =
,~ _ _ _, -~nr, D~:.TE REC. N0. A",'OUfJT ~==. ?~r_i
BARBARA BANGS 09/18/07 50329 25.00 CHECK 9513
210 MCKENZIE CT SE
YELM, WA 98597 BUDGETARY
Permit Fees Schedule
Permit No: BLD-07-0348-YL
Phone.
State. WA Zip 98597
Assessor Parcel No 82800000100
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
25.00 0.00 0.00 0.0000 0.0000 51,000
$25.00
DIANA
BLD-07-00348-YL
SITE: 210-SE MCKENZIE CT
~~~ ~-~;~-a3u~
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
,~ i
Project Address:~~ U 1`"~ ~C.tirfi3i~ L T S~~ Parcel #: _ ~ ~)(UQ~ (~ d / Q Q
Subdivision: Lot #: Zoning;
~ New Construction ~ Re-Model ~/ Re-Roof /..Addition ~l Home Occupation Sign
I Plumbing I Mechanical -~ Mobile /Manufactured Home Placement ~ I Other
Project Description/Scope of Work: ~itiM d~-(,~..~ ~' ~~~ ,~,• ~u;~ `' /' ~?~u.~ ~~(,lrl,~ ~ ' a-yl~~
Project Value: ,>>, .'Y%ll , C- 0
Building Area (sq. ft) 151 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? If yes, a
completed environmental checklist must accompany permit application.
BUILDING O~NEF~,NAME: ~- -~..
ADDRES 1 C~ { ~~~ ~ ~ MAIL ~ , - ~ vS
CITY ~.-t ~-.-~ STATE~y`~~ZIP S4'~~ TELEPHONE- 360 4 S~ 'K yG~
ARCHITECT/ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL 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 ce that the above information Is correct and that the construction on, and the occupancy and the use of the
above ~ ri ed property will be in accordance with the laws, rules and regulations of the State of Washington and the
Clty o~Yklrh.
I ~ r
1 l,~ ~ i ,
'~
Appli ants Signatt( 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
105 Yelm Avenue West
(360) 458-3835
PO Boar 479 (360) =158-3144 FAX
Yelne, WA 98597 u~wu~.cl.yelm.wa.tts