07-0122 Permit Pkg 032207~Of THFA~'~ City of Yelm
`Q
~ Community Development Department
Building Division
Phone: (360) 458-8407
L Fax: (360) 458-3144
A
li
t
pp
can
:
Name: Perkins Roofing
Address: P.O. Box 1085
P City: Yelm
roperty Information:
Site Address: 15942 Quail Meadows Ct. SE
Assessor Parcel No. 57630100200 Subdivision:
Contractor Information:
Name: Appliant Contact:
Address:
City:
Contractor License No: Expires:
Project Information:
Project: Smith Re-Roof
Description of Work: Residential Re-Roof
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other): OTHER
Fees:
Permit No: BLD-07-0122-YL
Issue Date: Issued ~~}~/C ~ j
(Work must be started within 180 days)
Receipt No: 47765
Phone: 360.458.5329
State: WA Zip 98597
Lot:
Phone:
State: Zip;
Business License:
Garage 0 Basement 0
Item ___ _ -` Item Fee Base Amt Unit Fee Unit Rate
Building Permit -Other 25.00 _ 0.00 Y~ 0.00 0.0000
TOTAL FEES: 525.00
Applicant's Affadavit:
No. Units Unit Desc
0.0000 $1, 000
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 conformit
it ~ OFFICIAL USE ONL~
y w
h all applicable City of
Yelm regulations including those governing zoning and land subdivision, and in addition
all covenants
easement
# Sets of Prints:
,
,
s and restrictions of record. If applying as a contractor, I futher certify that I am currently
registered in the State of Washington.
Final Inspection:
Signature ~ ~~=...L~~-- 3 ~~ G
Date Date:
Firm ~ ~Z-~1,~.~_ ~cyV1 ~ ~ 1 ~ 2-t/C, BY:
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Applicant:
Name: Perkins Roofing
Address: P.O. Box 1085
Project Information:
Project: Smith Re-Roof
Description of Work: Residential Re-Roof
Site Address: 15942 Quail Meadows Ct. SE
Fees:
Item Acct Code
Building Permit -Other 032 001-322-10-00
TOTAL FEES:
CITY OF
YELM
P.O. Box 479
Yelm, WA 98597
360-458-3244
RECEIVED
RECEIPT No. 4 r r 6 5
"`'"*"TWENTY FIVE DOLLARS & 00 CENTS
RECEIVED FROM DATE REC. NO. AMOUNT
PERKINS ROOFING 03/22/07 47765 REF.NO.
P.O. BOR 1085 25.00 CHECK ~04a~
YELM WA 98597 BUDGETARY
15942 QUAIL MEADOWS CT SE
City: Yelm
Permit Fees Schedule
Permit No: BLp-07-0122-YL
Phone: 360.458.5329
State: WA Zip 98597
Assessor Parcel No. 57630100200
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
25.00 0.00 0.00 0.0000 0.0000 $1, 000
525.00
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
(~ GT, S tz
Project Address: I S~ y Z Qu,~~-L Ih,eAJrx~,S Parcel #:
Subdivision: Lot #: Zoning;
New Construction 7C. Re-Model a-Ro Addition Home Occupation Sign
Plumbing Mechanical ~J Mobile /Manufactured Home Placement Other
Project Description/ScCOpe of Work: fa~~L ""r..eq.,`
PrniPr.t ValiiP~ I , 177 ,nr)
Building Area (sq. ft) 1S` 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 OWNER NAME: (~ k.
ADDRESS (5 u z ~- EMAIL
CITY t(~._ STATES~~/ZIP 1 TELEPHONE o2S - 9(.~-7R Fs`i ~w171Z.(`
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 fn 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
105 }'elm Anenue {'T'est (360) 958-3835
f'O I3ox 979 (360) •158-3199 F.4.1"
}'elm, TT'A 98597 «~et~u~.et.yelm.ma.us
~~~ ~~~ CITY OF YELM
2007
CLERK -TREASURER'S OFFICE
BUSINESS LICENSE
NOT VALlp U~;TIi ~F~ i; pain
_~
PERKINS CnNSTRiJCTION & ROOFINc3 INC_
35.317. 48TH AVF S
ROY WA 98580
AT 7 OUT OF TOWN
This License must be posted In a conspicuous oloce at 'he business location
07-002224.0
DEPARTMENT OI~ C,ABOR AND ItiDUSTRIES
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
REGIST. ##
CCO1 PERKICR995LN
EFFECTIVE DATE
PERKINS CONST & ROOT
PO BOX 1085
SPANAWAY WA 98387
EXP. DATE
01/10/2009
06/15/2001
'ING INC
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