Loading...
20100061 Permit Pkg 042210City of Yelm Community Development Department Building Division Phone: (360)458-8407 Fax: (360)458-3144 Applicant: Name: FREESTONEINC Address: 6820 20TH STREET E. SUITE A FIFE WA 98424 Property Information: Site Address: 92(16 CARYS ST SE 43 Expires: Assessor Parcel No.: 63520004300 Subdivision: MOUNTAIN SHADOW Lot: 43 Contractor Information: Name: FREESTONEINC Address: RICK CARLILE 6820 20TH ST E STE A FIFE WA 98424 Contractor License No.: FREESI'969NZ Project Information: Project: NEW RESIDENTIAL BUILDING Description of Work: SFR LOT 43, PLAN 2666 Sq. Ft. per floor: First 1195 Second 1471 Third Garage 415 Basement Fees: Permit No.: 20~ ~~~s~ Issue Date: 4/22/2010 (Work must be started within 180 days) Phone: 253-620-6416 Owner: FREESTONE INC. Phone: 253-896-1300 1 /24/2011 Heat Type (Electric, Gas, Other): GAS Item Contractor Fees NEW RESIDENTIAL BUILDING FREESTONE INC $13,233.68 MECHANICAL KLIEMANN BROS. $ 78.25 PLUMBING MCNEESES PLUMBING $ 118.00 TOTAL FEES: $ 13,429.93 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 wvenants, easements and restrictio s of record. If appJJJJ~~~~ng a contractor, I further certify that I am currently registered in th to ashi n. //~ ~/ /~ ( Signature /~N Hate ~ y ~ 0 Firm ~ CGS ~ rti~ /-~vtnN~~^ l "L ~ l~t~.~Dt.,l LL/' OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: City of Y~l« t aF.,O y 468-840 FtEC#: 00027403 4/1</2~G10 1:41 'rhi DPER: CD TER'ai: 001 REF#: TRAM: 33.OGG0 BIJiLDI't~5 F'ERi7ITS 2G1GOn~2 r2,1~i~~.34CR FREESTONE INC 9212 CARYS ST SE 42 r 12~1`.'t.~~3u%R gLD-R~5.1 TRA'rl: 33.G000 gull-DIF+r F'FR~iiTG 201400h2 78,25CF. FREESTONF_ INI; `x'12 CAR'VS ST SE 42 riECH 78.26CR TRAM: :,3.0000 gDILDIND F'ER"NITS 20100062 118.QOG'R FREESTDNE INC 921'2 CARYS ST SE 42. pL '_18.000R TRAM: :3.0000 gi:[I_DINC F'EFriIT~ 201000F~1 13 ~ 429.'i3CR FREESTONE INL' "20?~ CARYS ST SE 43 gLD-REST 13~23J.68CR MECH 78,26CR'. F'L 118.OOCR TEI;DERED: 26.822.4.5 CHECK 0.07 CASFI AF'RL IETi : 26 ~ 822.52- CHANGE: O.O~.i YELM COMNUNITY SCHOOLS PO BOX 476 YELM NA 96597 Clerk: Gerber Terminal: 1 Receipt: 124341 Manual Receipt: NFREESTONE MT SH NFREESTONE MT 5H FREESTONE, MT SHADOW, LLC 6820 20TH ST E SUITE A FIFE, WA 98424 4/22/2010 1:21 PM ~ty_ Item __._ Price 1 TVF MITIGATION 4280,00 MITIGATION Mt. Shadow 05-013 Lots 42 & 43 Subtctal: 4260.00 Tax: 0,00 Total: 4280.00 Check 4280.00 287 Change Due: 0.00 THANK YOU ~~'ock I'IAn ~~~6 2DI000(pl CITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM .2~~r-, ProjectAddress:~(Yn n ,~JJ,,,, ~X Parcel#:_ (p~r~~~~~J Subdivisionmr~i.,q~Vl ~~1-/(ityt~t #: '~ ~ Zoning; ~l'New Construction ^ Re-Model / Re-Roof /Addition ^ Home Occupation Sign ^ Plumbing ^ Mechanical ^ Mobile / Man~ufacture1d Home Placement ^ Other Project Description/Scope of Work:_~ Q I Cam. i'Y~ I l~ ~ S I p jQ(' Project Value: Building Area (sq. ft) 151 Floor~~ 2nd Floor j y~/ Garage y~ Deck Basement Carport Patio # Bedrooms5 # Bathroom~_~ Heating: GAS/ THER or ELECTRIC (Circle One) Are there any environmentally sensitive areas located on the parcel? L~ If yes, a completed environmental checklist must accompany permit application. ADDRESS~$ EMAIL ~ ?X mp CITY F~.`r'2 STATE ZIP TELEPHONE o'?.°~3-Rcl(O -( es . Cevn A~CH'T'Tt~;C7%ENGI"'~ ~-fJ'~C2 ICENSE # ADDR SS j~r~ MAIL ~( P I P,f 2X i 2(Nl CITY STATE U ZIP_ TELEPHONE INECHANj_C~LCONI'RAGTO^ t;vtn TELEPHONE ADDRESS ~ EMAIL CITYTY~COrY~t~-l STATE f~ ZIP ~I'-1 FAX~~-5~ -3 l0 CONTRACTOR'S LICENSE #~t-.~C M R H EXP DATEi-`~$~rY LICENSE # 1 y9, O 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 accoWance with the laws, rules and regulations of the State of Washington and the City of Yelm. 2 Applicant's Signature Date Owner /Contractor ner's Agen /Contractor's Agent (Please circle one.) All permits are non- a le 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 Auenue Weat PO Boz 479 Yelm, WA 98597 (360) 458- L5 rS V L~ (360) 458-3 IIIIII~~IIIIiI ruraru.ci.yel a.ua APR 0 2 2010 B Y- -------------- Lod ~3 MoUrt~ca~rn ~~~~.t~~~+l ~Zo~~ Ca~ys 5-~ s E P~c~c~l~ ~352~©0 ~-(300 5c~le I`~= 2~~ C o~r~e~~- y'' Pv c ~~a~-~' Dra.i,ns ~-~ 1~'~'~Wel~ ZS~~ ~ q ~ 1 ~ ~ ~ 2 Car l~ ,f~Z,3 ~~ I1 `~~ Y11 ~~- o 3 ~ M A ' _ -I~-dv v M - - - -_ V - ~~ M,~i-{r ~ 2.3~ 5 33303 1 ~zf /~Ppr~ovL~ ~~G~B~I~~ ~,~ ~ L`~-q~ /~ pPR 0 2 2010 ~~UUJJ ~~; `~c ~- ~ • B Y: -------------------- City of Yelm 105 Yelm Ave. W., Yelm, WA 98597 Phone: (360) 458-3244 Fax: (360) 458-0348 www.ci.velm.wa.us Application for Utility Service Date Received: Signature veriSed by: For City Use Onlv Owner Name: ' J?p0~tsy) t a n ~V'F tWL pwner Phone #: ~~~(p-/3~ Service Location: q~~ p , tom, r; ~- ~~ Start Date: y/I~ Mailing Address (If different than service location): ~~n ~~k~ ~ s Fi Crll~ G 4~PAl.( r~a.Q l'~ ~~~ ~~-1T°~"~ # ~ ~~7~ Date of Birth: Name of Employer: Employers Phone #: hereby make application for utility services from the City of Yelm, Washington, subject to all of the provisions of City Ordinances now existing or hereafter adopted and agree to pay all charges as provided for therein and that the obligations of the parties are covered thereby. This application shall automatically grant the City of Yelm the right to access the property for performance of.the City's services. I hereby certify that I am the legal property owner and have the authority to establish utility services at the above service location. ! understand the City of Yelm shall have a lien against the property in accordance with RCW 35.21 and RCW 35.67 of charges which shall be the obligation of the owner of the property, its heirs, successors and assigns, until the same is paid in full. The City may enforce the lien by shutting off and not restoring water and/or sewer until all delinquent and unpaid charges are paid in full. The City of Yelm may also employ other legal remedies such as collection agencies, small claims court or an attorney to collect the unpaid amount for the property owner. I understand if I put the billing in the name of my tenant and if the tenant fails to pay the utility bill I will be responsible for all charges including but not limited to utility bill, penalties and any other fees. Owners Signature: Date: ~/ (~ For my convenience, please est Ish a utility billing account for my tenant tall required information must be Provided in order to blll the tenant). Tenant name: Tenant Contact #: Requlred *Requlred Tenant mailing address: egwre e• ~P STATE OF WP;S~iINGTON COUNTY OF ll w~.~ On this day personally appeared before me l described in and who executed the within and the same as his/her/their free and voluntary Given under my hand and seal of office this Notary Public residing at ~ (~ ~---? My Commission Revised 12/16/09 sjd _ to me known to be the individual(s) and acknowledged that he/she/they signed =_s and purposes therein mentioned. 200 `~ ~, ~~~5 ~ ~~~~~ F ~ ,,, ~ ~ APR 0 2 2010 1J R Y•