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20100191 Sewer ERU Pymt 10082010City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (380) 458-3144 Applicant: Name: OUR REDEEMER LUTHERAN CHURCH Address: 805 YELM AVE E YELM WA 98597 Property Information: Site Address: 8Q5 YELM AVE E Assessor Parcel No.: 22730121100 Subdivision: Contractor Information Permit No.: 20100191 issue Date: 10/08/2010 (Work must be completed within 180 days) Phone: 360-458-7310 Owner: OUR REDEEMER LUTHERN CHURCH Lot: Name: OUR REDEEMER LUTHERAN CHURCH Phone: Address: FRANK LOOMIS 805 YELM AVE E YELM WA 98597 Contractor License No.: Expires: 0/00/0000 Project Information: Project: SEWER ERU Description of Work: Sq. Ft. per floor: First Heat Type (Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor Fees SEWER ERU OUR REDEEMER LUTHERAN CHURCH $ 6,050.00 TOTAL FEES: $ 6,050.00 OFFICIAL USE ONLY Sets of Prints: final Inspection: Date: sy: 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. If applying as a contractor, I further certify that I am currently ~tl~ ~~ ~~~ill - :4~ F., L ?:.~~• i~V7•' I. }R' . hI r ``~'['(i't , :.~_iy ~J~J~,IiJ ~JI ~ I.~ •I~T~~' 1 r~~~ TYi.t G-!_ 1!._ .~~.~~ I r .hr r...I rF~.