07-0134 Permit Pkg 032907~~OF TH~A~~ City of Yelm
~p Community Develo
d
Building Division
Phone: (360) 458-840
YEL Fax: (360) 458-3144
Applicant:
Name: Randy and Tawnya Gay
Address: PO Box 418
Property Information:
Site Address: 8505 Canal Road SE
pment Department
7
City: Yelm
Assessor Parcel No. Subdivision
Contractor Information
Name: Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: Gay Reroof
Description of Work: Tear off and reroof
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other):
Permit No: BLD-07-0134-YL
Issue Date: --fit Issued ~ I z' 1 ~ L
(Work must be started within 180 days)
Receipt No: 47833
Phone: 360-458-2018
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
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
OFFICIAL USE ONLY '
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 th State of Washington. Final Inspection:
Signature__ ~1 i Date '~
.~- ~~ J ~ ~ `1 c~~ Date:
Firm ~ By.
~~of TH~P ~C City of Yelm
R ~AiL~
.~ ,'p Community Development Department
Building Division ~; _~ r ~,, _
Phone: (360)458-8407
~.~ nc YELM
YEL Fax: (360) 458-3144 ,~ ~
Applicant:
Name: Randy and Tawnya Gay
Address: PO Box 418 City: Yelm
Project Information:
Project: Gay Reroof
Description of Work: Tear off and reroof
Site Address: 8505 Canal Road SE
Fees:
Item Acct Code
Building Permit -Other 032 001-322-10-00
TOTAL FEES:
Permit Fees Schedule
Permit No: BLD-07-0134-YL
Phone: 360-458-2018
State: WA Zip 98597
Assessor Parcel No.
Item Fee Base Amt Unit Fee
25.00 0.00 0.00
$25.00
Unit Rate No. Units Unit Desc
0.0000 0.0000 $1,000
%THE~
~` CITY OF
~ti;
q, ,
p YELM
- .
PO Eox ,-~ . ,~
RECEIPT No. ~ -
"
Yelm. ~/A 9859"
Ez seo a s-sz~-~
RECEIVED
TWENTY FIVE DOLLARS & 00 CENTS
. _ _ _~~ ern FROtiI DATE REC. NO. AP~1n'.1PJT RE'= tJO
GAY RANDY & TAWNYA 03/29/07 47833 25.00 CHECK 6401
8505 CANAL ROAD SE
P.O. BOX 418 BUDGETARY
YELM. WA 98597
MICHELLE
BLD-07-0134-YL REROOF PERZ`fIT
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: ~S `7C)~~ LC `+~c>~ rtici . Parcel #:
Subdivision: Lot #: Zoning; 2
\ -J
u New Construction ~e-Model / Re-Roof /Addition a Home Ocxupation Sign ~~/
u Plumbing a Mechanical a Mobile /Manufactured Home Placement u Other / `-'
i i co of Work: ~ ~
Protect Descr pt on/S pe ~
Ott : ~~ 1
Project Value: ~~~ ~-~
Building Area (sq. ft) 1~' Floor / 2"d Floor Garage Deck
Basement Carport Patio
# Bedrooms # Bathrooms ~ Heating: GAS/OTHER or~1=LECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
i~
GENERAL CONTRACTOR ~~ n.A_ TELEPHONE
ADDRESS C.. ~ ca-.~ ~~~ EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
PLUMBING 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.
1 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 n:gulatlons of the State of Washington and the
City of Yelm.
~~~ , ~ .~ _ ,3 , ~ ~~~. o ~
Applicant's Signatuf' Date
Owner J+Contracto~ 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
J05 Yeim Auenue West (360) 458-3835
PO Box 479 (360) 458-3144 FAX
Yelm, WA 98597 wrvu~.ci.yelm.wa.wv