20110118 Permit Pkg 02082011City of Yelm Permit No : 20110118
Community Development Department issue Date: 2!08/2044
(Work must be complatetl within 160 days)
Building Division
Phone: (360)458$407
Fax: (360)458-3144
Applicant
Name: YELM PROPERTY DEVELOPMENT Phone: _ 380_-458-0544
Address: P O BOX 2950
YELM WA 98597
Property Information:
Site Address: 16662 GREENLEAF AVE SE 88 Owner: YELM PROPERTY
_ DEVELOPMENT LLC
Assessor Parcel No.: 84070008800 Subdivision: WI LLOW GLEN III Lot: 88
Contractor Information:
Name: YELM PROPERTY DEVELOPMENT Phone: 458-0544
Address: DENNY BALASCIO
P O 80X 2950
YELM WA 98597
Contractor License No.: YELMpDL00302000 Expires: 2/20/2011
Project Informaton:
Project: NEW RESIDENTIAL BUILDING
Description of Work: LOT 88 PLAN 1596
Sq. Ft. per floor:
Heat Type (Electric, Gas, Other): GAS
First 730
Second 868
Third
Garage 720
basement
Fees
Item Contractor Fees
NEW RESIDENTIAL BUILDING YELM PROPERTY DEVELOPMENT 516.100.24
MECHANICAL SUNSET AIR INC S 78,25
PLUMBING TOP NOTCH PLUMBING INC f 111.00
TOTAL FEES: f 16,289.44
Applicant's Affidavit: OFFICIAL USE ONLY
I certify that I have read and exeminetl the information contained within the applicaGOn and know the same
to be true and correct. I also certify that the proposed strudwe is in conformity with ail applicable City of g Sets of Prints:
Yelm regulations including those governing zoning antl land subtlivision, and in addition. all covenants,
easements and restrictions of record. If applying as a contractor, I further Certify that I am currently Final Inspection:
registered ~ e State of W/a;l~'+~r+gton.
~~ (~~~ Date ~e/jt Date:
Signature
Finn By'
UItY Qf YE~~
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YELM P~~E%T`r C_CELOF~IF.t2T
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YELM COMMUNITY SCHOOLS
PU BOX 476
YELM kA 96597
Clerk: Croy
Terminal: 1
Receipt: 14579
Manual Receiat:
116ROCK T ON
NBROCKTON
BROCKTUN CONSTRUC1IiIN LLC, YELM PROPERTY
DEVELOPMENT LLC
x/8/2011 3:08 PM
0~ _,__iteir ___ . _ __.__._ Price
1 TVf MITIGATION 2780.00
MITIGATION
Nillo:u ;len III Lot p88
Suttotal: 2780.00
Tax' 0.00
Total: 2780.00
Check 2780.00
5374
Change Due; O.OU
THANK YOU
~Of(0!!~
CITY OF YELM
RESIpENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: /6G6 2 cr/~n/erg' ~ 5~ Parcel #: 9~1~70(7~ ~ ~ a
Subdivision: Nl1lDu1 Glentl .3 Lot #:~ Zoning; ~~
New Construction _ Re-Model / Re-Roof /Addition t Home Occupation Sign
Plumbing ~ Mechanical -i Mobile /Manufactured Home Placement ~ Other
Project Value: ~ ~~y'~~ -
L~
Building Area (sq. K) 1~' Floor 'Iw 2n° Floor SF ~ Garage' , t ~ Deck
# Bedrooms # Bathrooms3,7 Heatin :GAS/OTHE r ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? ~_ If yes, a
completed environmental chQCklist must accompany permit application.
BUILDING OWNER NAME: ~ rP~G'PErC'TY Ec~VE! MFA+~r ZCC
ADDRESS Z~'.So ,] ~J EMAIL
CITY V~i.ng STATE~ZIP7BJ-17 TELEPHONE ~/SS-~549
ARCHJTECT/ENGINEER Ejr,lE LrnlF LICENSE#
ADDRESS l014 E U'f~ EMAIL
CITY~rridrR- STATE+.Jr1 ZIP a8'iU! TELEPHONE 456 'E~BP,S
GENERAL CONTRACTOR ~LLC TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
PLUMBING CONTRACTOR iD IdoTCN TELEPHON~~ 08A3
ADDRESS ~O c(9r EMAIL
CITY JPMN]EZ STATE I,c.rh ZIP S7*+ FAX
CONTRACTOR'S LICENSE # EXP DATE_CJTY LICENSE #
MECHANICAL CONTRACTOR i[nlj~' d -rrt TELEPHONE 456-4956
ADDRESS SaJO L4C ~ EMAIL
CITY Uf__~STAT ,',/~ZIP SSP 3 FA,X _
CONTRALTO S LICENSE # EXP DATE_CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable.
I hereby cerUty that the above Information is correct and that the construction on, antl the occupancy anq the use of the
above described property will be In accortlance with the taws, rules and regulations of the State of Washington and the
City of Velm.
Applicant's Si nature Date
Owner / Cont ctor I Owner'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 1$0 days
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Fefm, till 98597 reuu.ri.yelm.um.us
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Projections less than 5 feet to property
lines shall provide fire-resistant construction
per IRC Table R302.1
WAC 51-51-0302 a.b
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