20120260 Permit Pkg 08282012City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: SOUTH PUGET SOUND HABITAT FOR
Address: 415 OLYMPIA AVE NE
OLYMPIA WA 98501
Permit No.: 20120260
Issue Date: 0 100 /0000
(Work must be completed within 180 days)
Phone:
Property Information:
Site Address: 412 YELM AVE EAST Owner: JUBE LLC
Assessor Parcel No.: 22719340500 Subdivision:
Contractor Information
Name: SOUTH PUGET SOUND HABITAT FOR
Address: CALEB
415 OLYMPIA AVE NE
OLYMPIA WA 98501
Contractor License No.:
Project Information:
Project: COMMERCIAL REMODEL
Phone:
Expires: 0 /00/0000
Lot:
Description of Work: DEMO INTERIOR WALLS, CONVERT RESTROOM INTO ADA FAMILY AND INSTALL RPBA
BACKFLOW
Sq. Ft. per floor: First
Second
Third
Garage
Basement
Fees:
Item
PLUMBING
COMMERCIAL ALTERATION
Heat Type (Electric, Gas, Other):
Contractor
SOUTH PUGET SOUND HABITAT FOR
SOUTH PUGET SOUND HABITAT FOR
TOTAL FEES:
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 in tho go ruing zoning and land subdivision, and in addition, all covenants,
easements and r tri so ece . If applying as a contractor, I further certify that I am currently
registered in th Stat f W on. /J /
Sinnature Data Q / ZA 7
Finn .50U -1 F2c76e 50VOWD !/MP17P71 TTY %jVM4Aili`l
Fees
$ 2700
$ 6843
$ 95.43
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
ƒƒ k
k
$@® �
k \\ �
3 \
� \SEE!
�
kk
ro
$ \ D
�
k
1'I
CITY @ YELM WES
105 YELM
X97
C�t�
YELM. WA-
958-8985
(36
krchanl 8819359573
Merchan! 870088819359573888
Term ID: Term ID; 8854
REC#
Sale
OPER
RED:
xxxxxmo
xxxxxxxaxxz9312 Entry Methodt Swiped
IYLSTEK9
NASTER 8
TRAN2
S
Paamt:
4ount: 0,00
Tax:
lax:
f ISM
Total:
Total:
Pl
14:21:52
BL
96/212
N/&12 Code: 61
Pow' 0212
Inv 9: a
Inv b: a0 s
TEN
Wvd:Onl
Ppprvd:Online
APP
Cust 4: 965
Cust q: 98591
CHAT
C.t° DopY
TH" Y00!
•
•
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: 4-4104414W 4/1Z VUIC#4 AW Parcel #:
Zoning; Current Use: Proposed Use:
❑ New Construction X Re -Model / Re -Roof / Tenant Improvement
❑ Plumbing ❑ Mechanical ❑ Fire Prevent/Suppress /Alarm ❑ Other
Project Description /Scope of Work: � 1 i-) u+n LV4L/ s
Project Value: 14606
Building Area (sq. ft) Parking Garage 1" FloorX_2n' Floor 3rtl Floor
Building Height
Are there any environmentally sensitive areas located on the parcel? N If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER/TENANT NAME: SOUTH Pu6&iE So. run W,*T F,6R j
RumAmj
ADDRESS LI M `/� t +'� AVt c hL;AS'T EMAIL LM( tD & SPS b2KaA r. eC
CITY \16- . STATE Ih t ZIP `t9R TELEPHONE Wb -4Q -2415[
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR SPS HA9111a'r TELEPHONE ?,%d- `ISM - ?41fK
ADDRESS 404- ol- ymPll+- Aim t, v4 EMAIL C&P -i-f' SPCHgItrmT, C
CITY ILY VM:Pi A- STATE 1M!4 ZIP q1 K-0 f FAX 3bb- 4q -34114'
CONTRACTOR'S LICENSE # Sov ?N P511 B K K 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).
I 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 Yet r.
Ap Icant's Signature Da
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 pgfioJJ gJ4PAl4y#.
irlV7 Len L6 WL
•
AUG 2 7 2012
105 Yelm Avenue West
PO Box 479 (360) 458 -3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us
0
0
•
M
x
Memorandum
City of Yelm
Community Development Department
To: Teresa Mattson, Treasurer
From: Tami Merriman, Associate Planner
Date: November 9, 2012
Subj: Refund of Assigned Savings for Habitat for Humanity
On October 12, 2012, Habitat for Humanity deposited $1,143.00 into an assigned
savings for the installation of required landscaping to receive a Temporary Certificate of
Occupancy for their retail establishment located at 402 Yelm Avenue East, Yelm, WA.
At this time, the landscaping is complete and approved.
Therefore, please prepare a check in the amount of $1,143.00 made payable to South
Puget Sound Habitat for Humanity, 415 Olympia Avenue NE, Olympia, WA 98501.
When the check is ready, please mail to the address above.
Thank you
Tami Merriman
January 24, 2013 Page 1 of 1