20050721 Permit Pkg 092606~~~,~ ~~=f ~,~~ City of Yelm
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Property Information:
Site Address: 1206 Crystal Ct. NW
Community Development Department
a
Building Division
Phone: (360) 458-8407
ELM Fax: (360) 458-3144
Applicant:
Name: McMullen, William
Address: 1206 Crystal Ct. NW City: Yelm
Assessor Parcel No. Subdivision
contractor Information:
Name: Applicant Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: McMullen Roof
Description of Work: Residential Reroof
Sq. Ft. perfloor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other):
Permit No: BLD-05-0721-YL
Issue Date: 09/26/2006
(Wo rk must be started within 180 days)
Receipt No: 43806
Phone: 458-4030
State: WA Zip 98597
Lot:
Phone:
State: Zip:
Business License:
Garage 0 Basement 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Building Permit -Other 25.00 0.00 0.00 0.0000 0.0000 $1,000
TOTAL FEES: $25.00
Applicant's Affadavit:
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 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 Date
By:
Firm ~
P.O. Box 479
Yelm, WA 98597
360-458-8403
RECEIVED ,~,-**TWENTX FIVE DOLLARS & 00 CEN'T'S
RECEIVED FROM DATE REC. NO.
WIZ~LIAM f~fCMULLEN 09 / 2 5 / 06 ~ 3806
1206 CRYSTAL C.T NW
YEI.M, WA 98597 BUDGL7TARY
RECEIPT No. 4 3 g ~ 6
AMOUNT REF. NO.
25.@0 CHECK 3021
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CITY OF YELM
RESID.~E.,tN~T/IA/~L/BU~IL9DIN~GQPERMIT APPLICATION FORc~M
Project Address;~I~p~y5~G41 l,-T> >lJ ~ UJ + Parcel #: ~~.~ /~'Ct ~ ~ ~~"~
Subdivision: Lot #: Zoning;
^ New Construction ^ Re-Model / Re-Roof /Addition ^ Home Occupation Sign
^ Plumbing I i Mechanical CI Mobile /Manufactured Home Placement ^ Other
Project Description/Scope
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city P,
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Project Value:
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 OWNE E: t 114 l.C. ~
ADDRE ~ EMAIL
CITY ATE 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 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
City of Yelm.
Applicant's Signature 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
I05 Yelm Acrenue West (360) 458-3835
PO Box 479 (360) 458-3144 FA.Y
}'elm, WA 98597 mu~u~.ci.yelm.u~a.us