07-0354 Permit Pkg 092007~OF TAP City of Yelm
Community Developmen
d t Department
Building Division
Phone: (360) 458-8407
EL Fax: (360) 458-3144
Applicant:
Name: Gary's Home Repairs
Address: 17617 Old Barn Road City: Yelm
Property Information:
Site Address: 103 SE View Drive
Assessor Parcel No. 81620003100 Subdivision:
Contractor Information:
Name: Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: Stover Reroof
Description of Work: Tear off and reroof
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other):
Permit rvo: BLD-07-0354-YL
Issue Date: 09/20/2007
(Work must be started within 180 days)
Receipt No: 50350
Phone:
State: WA Zip 98597
Lot:
Phone:
State: Zip:
Business License:
Garage 0 Basement 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate
Building Permit Other _ 25.00 ~ 0.00 ~ 0.00 ~0.0000
TOTAL FEES: $25.00
No. Units Unit Desc
0.0000 $1, 000
SCANNED
FEB 1 1 201u
Applicant's Affadavit:
I certify that I have read and examined the information contained within the application and know the same
OFFICIAL USE ONLY
to be true and correct. 1 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. # Sets of Prints:
easements and restrictions of record. If applying as a contractor, I futher certify that I am currently
registered in the Stag of Washingt9fi.
~
Final Inspection:
' ~
i
Signatur ~ Date 7 ,~ Z e p -~
•~-
Date:
Firm By:
P.O. Box 479
Yelm, WA 98597
360-458-3244
RECEIPT No. 5 0 3 5 0
RECEIVED ****TWENTY FIVE DOLLARS & 00 CENTS
RECEIVED FROM DATE REC. NO. AMOUNT REF. NO.
GARY'S HONE REPAIRS 09/20/07 50350 25.00 CASH
17617 OLD BARN ROAD
YELH. WA 98597 BUDGETARY
HICHELLE
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION~FrOR~M
Project Address: /l~ ~ /~ ch t v -~-c.2 ~~~^ Parcel #: ~ ~ ~ ;w.~.~_~, ~ ~ ~~
Lot #: Zoning;
^ New Construction ~ Re-Model / Re-Roof /Addition i 1 Home Occupation Sign
h Plumbing ^ Mechanical ~ ~~] Mobile /Manufactured Home Placement ^ Other
Project Descri lion/Scope off 1Work:~ ,?~ - D ~ y- r~ I"OC~
Project Valu~ ~ ~ ~ ~~/
Building Area (sq. ft) 1 S` 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.
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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 certify 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
Clty of Yelm.
i
Applica s Slgnatu a Date
Owne /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 Y'elm Avenue t4'est (360) a58-3835
PO Box d 79 (360) a58-31 ~1-1 FA.Y
Felm, WA 98597 u~u~m.ci.yelm.u~n.us