20100033 Permit Pkg 021210City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: FIT STOP
Address: P.O. BOX 13278
OLYMPIA WA 98508
Property information:
Site Address: 16910 HWY 507 owner:
Assessor Parcel No.: 64303100800 Subdivision:
Contractor Information
Name: FIT STOP
Address: MICHELLE LAWRENCE
P.O. BOX 13278
OLYMPIA WA 98508
Contractor License No.:
Project Information:
Project: PLUMBING
Description of Work:
Sq. Ft. per floor: First
Second
Third
Garage
Basement
Fees:
Item
PLUMBING
COMMERCIAL ALTERATION
Contractor
FIT STOP
FIT STOP
TOTAL FEES:
Applicant's Affidavit:
I certify that I have read and examined the information contained within the application and know the same
to be true and correct. f also certify that the proposed structure is in conformlly 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 further certify that I am currently
registered in the Stat of Washin ton ~/fJ/~ ~~
Signature `~.~~ ~~~' -! / Y - Date ~-~Z/D
Permit No.: 20100033
Issue Date: 2112/2010
(Work must be started within 180 days]
Phone: 360-400-4000
CROSSROADS AT YELM LLC
Lot:
Phone:
Expires: 0/00/0000
Heat Type (Electric, Gas, Other):
Fees
$ 6,286.00
$ 0.00
s s,2ss.oo
of Prints:
Inspection:
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CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: /6 9/D ~f-,B~ 5"y 7 .~~ Parcel
Zoning; C - 3 Current Use: ~ET.4iL Proposed Use: ~ET!!~iL
New Construction K Re-Model / Re-Roof enant Im rove
Plumbing Mechanical Fire PrevenUSuppress/Alarm Other
Project Description/Scope of Work: Ll~ / S~/f`z/~~e ~Z f/A~.1/~T~S ~Cosag~T ?v S~s/e~E'
Project Value: C uoo
Building Area (sq. ft) Parking Garage 1°' Floor Sao 2nd Floor 3`d Floor
Building Height /2 ,
Are there any environmentally sensitive areas located on the parcel? if/ r? If yes. a
completed environmental checklist must accompany permit application.
ARCHITECT/ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR Qu/rtl~~ TELEPHONE
ADDRESS EMAIL
CITY _STATE ZIP FAX
CONTRACTOR'S LICENSE tt FXP DATE CITY LICENSE #
Copy of Cky Mltlgatlon documentation (TFC).
1 fwreby certify that the above Informstlon b correct and that the construction on, and the occupancy and the use of the
above described propeRy will be In accordance with the laws, rules and regulations of the State of Washington and the
City of Yelm.
i ~ yy /~/O
Applicant's Signature Date
Owner /Contractor /Owner's Agent / Contf~actor's Agent /Tenant (Please circle one.)
All permits are non-transferable and will expire tf work authorized by such permit i~ G~ ~ V
within 180 days of Issuance, or if work is suspended or abandoned for a period of 18
~'
~~ FEB ~ ~.~ 20~~
I05 Ytlm Ac~enue West
PO Bos 479
}'elm. WA 98397
(360) X58-3833
(360) 458-3144 FAX
u~ww.cl.yelm.wa.ua
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