20100035 Permit Pkg 030210City of Yelm
Community Development Department
Building Division
Phone: (380) 458-8407
Fax: (360) 458-3144
Applicant:
Name: NOBLE THERAPY ANYTIME FITNESS
Address: 1304 YELM AVE E, BLDG A108
YELM WA 98597
Property Information:
Site Address: 130d YFI M AVF F A 1(1R
Assessor Parcel No.: 22730140100 Subdivision: CREEK STREET Lot:
Contractor Information
Name: NOBLE THERAPY ANYTIME FITNESS
Address: STEPHANIE JACOBS
1304 YELM AVE E, BLDG A108
YELM WA 98597
Contractor License No.:
Permit No.: 20100035
Issue Date: 3/02/2010
(Work must be started within 180 days)
Phone: 360-400-3880 WORK
Owner: MARK IRELAND
Phone:
Expires: 0/00/0000
Project Information:
Project: COMMERCIAL REMODEL
Description of Work: NEW THERAPY ROOM IN ANYTIME FITNESS
Sq. Ft. per floor: First 108 Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor
BUILDING NOBLE THERAPY ANYTIME FITNESS
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. 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.
easements and restrictions of record. t( applying as a contrac u er certify that I am currently
register Scat f W
Si Da a
Firm
Fees
$ 63.93
S 63.93
Inspection:
Ci t~ of Y~Im
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~~ ~ 00022918 3/02/2010 4:15
Gam: CD TE:~I: 001
kEfD: t4C
EkAB: :x.0000 I~JIIDING PEf~IITS
20100035 h3, 93Ck
~]REE TI~RAI'1' ANYTIt~ FIVE
RLDGl~+ ~~ Ali E A 108
h3.93CR
TENDERED: h3.93 GTfER
Aff"~IED: 63.93-
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Project Des ~ lion/Scope of Work: ~~ I ~ ~ ~ h ~ l i ~ ((~- ~ l`' ~ 1" d ~ ~ ~ ` ~ ~ t 1 I ~ J
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CITY OF YELM l "~~ ~y3 ~ S 3 ~ ~
COMMERCIAL BUILDING PERMIT APPLICATION FORM ~'~'^t
Project Address: ( Ili Ili{ ( ~~~ rl ~~ Parcel #:~71~~/ ~,IC~fvO
~l ~l'1C55 C ~u i -
Zoning; Current Use: ~='r~uN~~~u ..~~.
New Construction Re-Model / Re-Roof /Tenant Improvement ,
Plumbing Mechanical Fire PrevenUSuppress/ larm Other
Are there any environmentally sensitive areas located on the parcel? •~ U If yes, a
completed environmental checklist must accompany permit application.
Buitd~n~~~ (~qT ft)( I ~ riccing Garage 1" Floor 2n0 Floor 3rtl Floor
Bwlding Heig~t 1
,~' ~ 1 nN v
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GENERAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
Copy of Clty Mitigation documentation (TFC).
I hereby certify that the above Information is correct and that the construction on, and ttw occupancy and the use of the
show described property will be in accordance with the laws, rules and regylatlons of State of ashington and the
Cky of Yalm. ~- ~( C~ S~'~nll~llll ~ ~Al C~S
~~ ~~ ~(.~ ~~r
Applicant' Signatyre Date
Owner / Contractory ner's Agent /Contractor's Agent /Tenant (Please circle one.)
All permits are non-transferable and will expire if work authorized b such permit is not begun
within 180 days of issuance, or if work is suspended or abandon ~~~ s
FEB o 1 2010
103 Yelm Auenue West
1'O Bos 479
Ytlm, WA 98597
8 Y:
(360) 458-3833"
(860) 458-3144 FAX
mmu•.ci.yelm.tna.ue
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