07-0199 Permit Pkg 052307~OF THEP~ City of Yelm
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Community Developme
nt Department
Building Division
Phone: (360) 458-8407
L Fax: (360)458-3144
A
li
pp
cant:
Name: Williams, Wayne
Address: 16740 Port Oxford Blvd City: Yelm
Property Information:
Site Address: 204 McKenizie Ct.
Assessor Parcel No. 8280000700 Subdivision:
Contractor Information:
Name: Applciant Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: Fritz Riddle
Description of Work: Re-roof
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other): OTHER
Permit No: BLD-07-0199-YL
Issue Date: Not Issued
(Work must be started within 180 days)
Receipt No: 48751
Phone: 458-3077
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 Y0.00 0.0000
TOTAL FEES: $25.00
No. Units Unit Desc
0.0000 $1,OOOv
~~
Applicants 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.
Signature ~ , Date ~ f 2~' d
Firm
OFFICIAL USE ONLY
# Sets of Prints:
°Inal Inspection:
Date:
By.
RECEI'dED
CITY OF
YELM
P 0. Jinx 479
Yelm, WA 9x597
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RECEIVED FROt,4
1'],,';,N ]9TH - - DATE REC. NO.
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RECEIPT No. ~~ ~~ '' ~~ ~
AMOUNT
REF, N0.
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RESIDENTIAL BUILDING PERM T APPLICATION FORM
ProjectAddress:~(,~ j~/~,~ 1'1~(~.i;~7~ 1--
Subdivision: Lot #:
Zoning;
u New Construction -+,~R~M~eI / Re-Roof /Addition
u Plumbing u Mechanical u Mobile /Manufactured Home P aocem OctcupabU Other
Project DescriptioNScope of Work:_•~ et~~' (~,~ I ~e-~(~{=
Project Value: ~ ~~;
CITY
CITY
CON"
CITY
Building Area (sq. ft) 1 ~' Floor tii ~,~JD 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?
completed environmental checklist must accom an If yes, a
p y permit application.
Copy of mitigation agreement with Yelm Community Schools, if applicable.
I hereby certify that the above iMormatlon is correct and that the construction on, and the occupancy and the use of the
above described property wi11 be In accordance wkh the laws, rules and regulations of the State of Washington and the
City of Yelm.
~ ~ '1
_ ~ z~ d
Applicant's Signature
Owner /Contractor /Owner's Agent / C tractor's Agen~(Please circetone.)
-- - -~f
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
70.5 Yelm Avenue Weat
PO Box 499 (360) 458-3835
Yelm, WA 98599 (360) 458-3144 FAX
uuuu~. ci.yelm.mn. 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.
Busfness Owner Information
Name Effective Expiration
Role Date Date
WILLIAMS,
WAYNE A PARTNER/MEMBER 04/27/2006
WILLIAMS,
TONIE R PARTNER/MEMBER 04/27/2006
Bond Information
https://fortress.wa.gov/Ini/bbip/Detail.aspx?License=WgyNE WC942J7
`-- - 5/23/2007
Luox up a Contractor, Electrician or Plumber License Detail
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Bond Bond
Company Account Effective Ex
Bond Name Number Date Piration Cancel Impaired Bond
Date Date Date Received
Amount Date
rf1 CBIC SG6409 Until
04/01 /2006 Cancelled
512,000.00 04/27/2006
Savings Information
No Matching Information
Insurance Informati~.,
_..._ ~.umoer Date - --~-•~ ~a~ice
#1 CBIC Date Date
C11SG6409 03/30/2006 03/30/2008
Summons /Complaints Information
No Matching Information
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~ 5/23/2007