20120213 Permit Pkg 07032012�o T . City of Yelm pear^^ No' 20120213
Community Davelopment Department bwe Days MGM
x IS ®'-_"' Building Orolaion lwnm mul6e mnoM.a vMmlW a.vq
PM1aM:(NO)a5 7
L Fax: (360)M 31M
Applicant
Name'. MARINATWIGGS Pflwe.
Address: P.O. BOX 28W
YELM WA g 7
ProwM lnwrmadon:
site Addreee 15805105TH WAY BE Gm.r: JEFF AND MARINA TWIGIS
Aeseesa Parcel No.. 22]]01101101 SuMlvNon: Lot:
Cwtrmd rlMamation:
Name: M4RINAlWIGGS PM1mre:
Address:
P
YELM VIA 9807
Cormredw Llcenae No Extiond OSOONO011
PNject lnbmlatlan:
Premed ROOF
Deunadhom mwan'.
Sq. FL per flow: First Heel Type IEleddo Gas, Oil
seroM
Third
Garage
Basencem
Fe":
Inner Centeclgr Fees
ROOF 1MRIN4TLM a 2500
TOTAL FEES: a WOO
ApplluMSAKaaNL' OFFICVL O6EQYLV
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On W Me and ci lake All the waxnaM ISNOWS 3 e Owfi y Mem all goiwbW CIO O gSeb dPdnb:_
Yale rindelons,111ne June goveming oreno and land aubdieoon, ant b Sol all Overall
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fin 0Y'
City of yell
8 , 456-8402
RECY; 00099523 7/03/2012 2:22 PN
ROEFN; PER: CC TERM: WI
IRAN: 33-0000
20120213
WILDING PERMITS
155305510
25.00M
THRMAY SE
RWF
5.WER
TEWEREO:
pPPLIEp:
CASH 4p,p0
25.w_
CHANGE
15 w
CITYOFYELM
RESIDENTIAL BUILDING P�E(,R,MR L APP (CATION FORM
• Prgeat AtlaressJ58 D6 IDS- �,Ja4 FTPara in
Subdivision'. Lolp'. .•ll Flan #: Zaning:
'I New Construction ({(Re.Metlel I Re -Roof l Addition Home Oaupatim Sign
Plumbing I Mechanical I Mobile l Manufactured Home placement a ONrer
Projay OesMplioNSooped Work kY4/� NfSll Crtt7T
Pm)ecl Value:
Bulidin0 Area(sq. X) P'Floa_�m— 2n0 Flow Garage Dark_
,1 Basement Carson Patio_
E Betlmom A- aBathnoomsl Healing: GASIOTHER or ELECTRIC (Circle One)
Are Nare any enNmnmentally senerme areas located on the pradmi
Ryes, a completed environmental chmakn5t must accompany permlt apprelion.
BOILOING 0WNERMAME, ZLCC—A—i mA 5
ADDRESS VD FDk Ari55a. EMAIL
CRY VPLM STATE- yg_ZIPdllic�l TELEPHONE 92/0
ARCHRECTIENGINEER LICENSE
ADDRESS EMAIL
CITY STATE___ZIF TELEPHONE
GENERAL CONTRACTOR TELEPHONE
• ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# E%P DATE_CITY LICENSEE
PWMBINGCONTRACTOR TELEPHONE
ADDRESS EMAIL
CRY STATE ZIP FPX
CONTRACTOR'S LICENSE A EXP DATE CITY LICENSE
MEC NICALCON CTOR TELEPHONE
ADDRESS EMMIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE p E%P iATE CITY LICENSEE
Copy of mitigation agreement wit Y¢Im Commonly Schools, if applimme .
xarWyuaty e er ti he ineemn Iv mnd vne uvruamnaeunan en, mauea..upugoneua uandma
ewe.m aIII a i..xwe.a.. am m. I..,, a,w.aa wamwa�. d m. m. d wmmaema .aa me
clwdv.Im.
mi�p��l•.A— R �W Dmal
=,,Corti r r Overseas Agent l Contractors Agent(Pieaso cimie one.)
All demai4 are non-trans(enble and will expire If work aWM1Ofized by such permit is nW begun
w@M1ln 180 days of issuance, or If work is suspended or abandoned fora period of IN days
11 (360149848S5 Per. End Uses w New o -elff FM