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20110124 Permit Pkg 01202011City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Applicant: Name: CITY OF YELM (I) Address: 105 YELM AVE W YELM WA 98597 Property Information: Site Address: 9AR SF[_11N1~'1 CT CF 1 Assessor Parcel No.: Contractor Information Name: CITY OF YELM (I) Address: 105 YELM AVE W YELM WA 98597 Contractor License No.: Project Information: Project: BUILDING Permit No.: 20110124 Issue Date: 1/20/2011 (Work must be completed within 180 days) Phone: 360-458-3244 Owner: CITY OF YELM Phone: Expires: 0/00/0000 Description of Work: PARTITION WALL FOR SCADA SYSTEM Sq. Ft. per floor: First Heat Type (Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor Fees BUILDING CITY OF YELM (I) $ 0.00 TOTAL FEES: $ 0.00 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 reg lations including those governing zoning and land subdivision, and in addition, all covenants, easeme sand res rictions of record. If applying as a contractor, I further certify that I am currently Subdivision: Lot: 'ICIAL USE ONLY s of Prints: Inspection: Firm ~ I By: ~oIIC~ 12 CITY OF YELM COMMERCIAL BUILDING PERMIT APPLICATION FORM Project Address:2.~~0 2'~`~ ~- . Parcel #: Zoning; Current Use: Proposed Use: New Construction - Re-Model / Re-Roof /Tenant Improvement Plumbing Mechanical -Fire Prevent/Suppr~es~s/Alarm ,Other Project Description/Scope of Work:_ Y)C~-~~~(Sk ~-c~cL~ 1 ~ SCG~~GL. SI~~dL'-l~tn. Project Value: _G ~'\,I n ['_ Building Area (sq. ft) Parking Garage 1 S` Floor 2"d Floor 3`d Floor Building Height Are there any environmentally sensitive areas located on the parcel? If yes, a completed environmental checklist must accompany permit application. ~r~ ~~ • • GENERAL CONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE_CITY LICENSE # PLUMBING CONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # MECHANICAL CONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # Copy of City Mitigation documentation (TFC). 1 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 City of Yelm. ~ :~_ v-~~ 1 v L Applicant's Signature Date Owner /Contractor /Owner's Agent /Contractor's Agent /Tenant (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 I05 Yelm Avenue West PO Box 479 Yelrn, WA 98597 (360) 45 ~ ~ y~ y7 (360) 45 V www.ci. .wa.us .:~ B Y: -------------------- G7 • ~ ~,, '~ ~. ~ ~~ ,~ ; . a o ~ a vim`' ~~`~: j'~v~s ~W ~ c~c_ ~I ,f 4 - _ t,. iZo1,` u~ \'Cjpn~ ~' 96 ~~ 17 ~~= t~ 3 ~~_ `~ II I