20050072 Permit Pkg 03112005City of Yelm
Community Development Department
Building Division
Phone: (360)458-8407
Fax: (360)458-3144
Applicant:
Name: Alfred Wallace
Address: 15921 Quail Meadows Ct. City: Yelm
Property Information:
Site Address: 15921 Quail Meadows Ct.
Assessor Parcel No. 57630101400 Subdivision:
Contractor Information:
Name: Applicant Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: Wallace Addition
Description of Work: 648 sf. Addition
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other): OTHER
Fees:
Item
Building Permit -Other
Building Plan Review
Plumbing Permit
State Building Fee
TOTAL FEES:
Permit No: BLD-05-0072-YL
Issue Date: 03/11/2005
(Work must be started within 180 days)
Receipt No: 35868
Phone: 458-9671
State: WA Zip 98597
Lot:
Phone:
State: Zip:
Business License:
Garage 0 Basement 0
Item Fee
------ Base Amt Unit Fee Unit Rate No. Units Unit Desc
-----
565.98 -----------
0.00 -----------
0.00 -----------
0.0000 -----------
0.0000 -------------
$1,000
367.88 0.00 0.00 0.0000 0.0000
48.00 20.00 28.00 7.0000 4.0000 Fixture
4.50 4.50 0.00 0.0000 0.0000
$986.36
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 c t the proposed structure is in conformity with all applicable City of #
Yelm regulations including th a gover ing zoning and land subdivision, and in addition, all covenants,
ease restric ~ record. I applying as a contractor, I futher certify that I am currently i
regi red in the a of Wa ington. _ Fi
Signa "~ Dat
Firm
Sets of
Inspection:
Date _`v'/1 ~'J _~'
By: _
%~°`"'F^~,~I CITY OF
a m YELM
P.O. E3ox 479
vPim, wa 9ss97 RECEIPT No. 3 5 8 6 8
YELM 360-458-B4U3
RECEIVED
****NINE HUNDRED EIGHTY SIX DOLLARS & 36 CENTS
RECEIVED FROM DACE REC. N0. AMUUNI REF. NO.
WALLACE 03/11/05 35868 986.36 CHECK 3172
15921 QUAIL MEADOWS CT.
YELM WA 98597
BLD-05-0072-YL
SITE 15921 QUAIL MEADOWS CT. t4ISCELLANEOUS RECEIPT
MICHELLE
WALLACE BLD PMT 565.98, PLAN REV 367.88, PLUM PMT 48.00, BUIL FEE 4.50
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: Alfred Wallace
Address: 15921 Quail Meadows Ct.
Project Information:
Project: Wallace Addition
Description of Work: 648 sf. Addition
Site Address: 15921 Quail Meadows Ct.
Fees:
Item
Building Permit -Other
Building Plan Review
Plumbing Permit
State Building Fee
City: Yelm
Permit Fees Schedule
Permit No: BLD-05-0072-YL
Phone: 458-9671
State: WA Zip 98597
Assessor Parcel No. 57630101400
Acct Code Item Fee Base Amt Unit Fee
032 001-322-10-00 565.98 0.00 0.00
100 001-345-83-00 367.88 0.00 0.00
032 001-322-10-00 48.00 20.00 28.00
160 001-386-00-00 4.50 4.50 0.00
TOTAL FEES: $986.36
Unit Rate No. Units Unit Desc
0.0000 0.0000 $1, 000
0.0000 0.0000
7.0000 4.0000 Fixture
0.0000 0.0000
PAI D
M~,~ ~ 1 2005
CITY OF YELM
CITY OF YELM
RESIDENTIAL B ILDING PERMIT APPLICATION FORM
~i~
Project Address: ,Parcel #: ~ ~~% ~~ ~ C I ~ ~F/ eCe1Ved
Subdivision: Lot #: Zoning;
u New Construction ~ Re-Model / Re-Roof /Addition u Home Occupation Sign
u Plumbing u Mechanical u Mobile /Manufactured Homec_P,.-lacement u Other
Project Description/Scope of Work:~~~~~~~ .~I,C~ ~~~~~L'~~
Project Value:
Building Area (sq. ft) 1~ Floor 2"d Floor Garage Deck
Basement Carport Patio
# Bedrooms- # Bathrooms- Heatin : GA THER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? --~~ If yes, a
completed environmental checklist must accompany permit application.
MAR 0 g 2005
BUILDING OWNER NAME: I
ADD S EMAIL _ ~~~
CITY STATE ZIP TELEPHONE -l ~
ARCHITECT/ENGINEERS,~INOInC~~ LICENSE
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL
5 1 A I t uw~~ r~ ~---
LICENSE # (~ EXP DAT~~ITY 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 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 d cribed p rty will be in accordance with the laws, rules and regulations of the State of Washington and the
Cky of a m.
c~ Gam' ' C5
plicant's Signat re Date
Owner /Contractor /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 180 days
105 Yelm Auenue Weat (360) 458-3835
PO Box 479 (360) 458-3144 FAX
Yelm, WA 98597 rvmrv.ci.yelm.wa.ua
i ~:
4
MAR 0 8 2005
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