07-0181 Permit Pkg 050307iJ 'G- Community Development Department
~e Building Division
Phone: (360) 458-8407
E w~~ ~,o. Fax: (360) 458-3144
Applicant:
Name: LB:G
Address: 10231 Kiwa Drive SE City: Olympia
Property Information:
Site Address: 408 2nd St SE
Assessor Parcel No. 22719330803 Subdivision:
Contractor Information:
Name: Applicant
Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: United Methodist Church
Description of Work: Tearoff and reroof
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 230.25 0.00 0.00
TOTAL FEES: 5230.25
Applicant's Affadavit:
Permit rvo: BLD-07-0181-YL
Issue Date: Not Issued
(Wo rk must be started within 180 days)
Receipt No: 48485
Phone: 360.480.9376
State: WA Zip 98513
Lot:
Phone:
State: Zip:
Business License:
Garage 0 Basement 0
Unit Rate No. Units Unit Desc
0.0000 0.0000 $1 000
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. 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, # Sets of Prints:
easements and restrictions of record. If applying as a contractor, I futher certify that I am currently
registered in the State of Was ngton. .Final Inspection:
Signature Date ,~ ? ~ Date:
--~ ~S•
Firm . ~ G ~ k~-1 /4 C' _ By.
CITY OF
YELM
P 0 fox 419
Yelrn. WA 9597
3fi6-458-3244
:,FINED ,., rmlg0 HUNDRED THIRTY Dr)LLARS f~ ~5 CF'`iTS
RECEIVED FROM DATE REC. N0.
OL'iiIPIA, i'i;'i 9 ` 1 ? F3IJDGETARY
SITE 9~8 CECOND ST SE
U2dITED ifETIi~~DINT CHURCH
„~
RECEIPT No. '~
AMOUNT
REF N0.
^~"
tiICH)1L?~L
-PLC-~~?-lli?.t-°,'L
City of Yelm
Community Development Department
Building Division
Phone: (360)458-8407
Fax: (360)458-3144
Applicant:
Name: L&G
Address: 10231 Kiwa Drive SE
Project Information:
Project: United Methodist Church
Description of Work: Tearoff and reroof
Site Address: 408 2nd St SE
Fees:
Item Acct Code
Building Permit -Other 032 001-322-10-00
TOTAL FEES:
Permit Fees Schedule
h~~ Permit No: BLD-07%0181-YL
~~,~ ~ ;3 L~C1 I
G~~ ~
Phone: 360.480.9376
City: Olympia State: WA Zip 98513
Assessor Parcel No. 22719330803
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
230.25 0.00 0.00 0.0000 0.0000 $1,000
$230.25
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: Parcel #:
Zoning; Current Use: Proposed Use:
U New Construction U Re-Model / Re-Roof /Tenant Improvement
U Plumbing U Mechanical U Fire Prevent/Suppress/Alarm U Other
Project DescriptionlScope of Work: ~ ~ ~ ~ d
Project Value: f ~ , Z G3 C' , u r-
Building Area (sq. ft) Parking Garage 1~' Floor 2nd Floor 3"d Floor
Building Height a? a Q ` ~~
1" G c' Qc t/` v ~ 1
PLUMBING CONTRACTOR
EXP
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE_CITY LICENSE #
Copy of Clty Mklgation documentation (TFC).
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 wkh the laws, rules and regulations of the State of Washington and the
City of Yelm. / _
F-i ;
-~ ~i ~ ~- 7
Ap 'ant's Signature Date
Owner (Contractor /Owner's Agent I Contractor's Agent /Tenant (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 Ai+enue Weat (360) 458-3835
PO Bor 479 (360) 458-3141 FAX
Yelm, WA 98597 u~u~rv.ci,velm.u~a.ua
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.