20180325 CL 1 ApplicationCITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 9423 Prairie Wind St SE
Subdivision:
Parcel #:
Coles Landing Lot #: 1 Plan #: 2123-2
Zoning:
/ New Construction 11 Re -Model / Re -Roof /Addition F1 Home Occupation Sign
11 Plumbing 11 Mechanical El Mobile /Manufactured Home Placement 11 Other
Project Description/Scope of Work: Construct SFR
Project Value:, $125,000
Building Area (sq. ft) Vt Floor 876 2nd Floor 1247 3rd Floor Garage -2 car 377 3 car
Covered Patio Covered Porch 77 Patio 80 Deck
# Bedrooms # Bathrooms�2.5 Heating <FOTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? No
If yes, a completed environmental checklist must accompany permit application.
KINIMNOWMMuountawn Terrace Builders
ADDRESS301 F Yelm Ave STE 100 EMAIL MTBpurchasffinq0UmamI.corn
CITY _Yelm _STATE WA ZIP X18.597 TELEPHONE -
1Rn 4S8 1509
KINEMMMMK_ Level Design LICENSE #
ADDRESS 611 S Yakima Ave EMAIL
CITY Tacoma STATE \/\IA ZIPM405 -TELEPHONE
TELEPHONE
ADDRESS -EMAIL
CITY STATE -ZIP FAX
CONTRACTOR'S LICENSE #-MQJU-TATB890BSEXP DATE31jD-CITY LICENSE # go,
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253.�I;�:;°N�'I" �::T`:. TELEP
405.2499
ADDRESS 17909 Kismet Lane SE EMAIL
CITY Yelm STATE 'WA ZIP 98597 FAX
CONTRACTOR'S LICENSE # JRSPLI*975D5 EXP DATE3/19CITY LICENSE # 602.264.092
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ELEPHONE 253. 536.3357
ADDRESS 1201 E Yelm Ave STE 400 EMAIL
CITY Yelm STATE WA _ZIP 98597 FAX
CONTRACTOR'S LICENSE# PREMIGC884RJ EXP DATB2/18CITY LICENSE# 603.257.522
I 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
Cl of Yelm.
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caht''W" nature Date
wner/ ntractoOwner'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 Yelm Avenue West (360) 458-3835
Yelyn, WA 98597 (360) 458-3144 FAX
wwwA.yelm,wa.us