20120265 Permit Pkg 09052012City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: UNCLE ROY'S MUSIC
Address: PO BOX 2252
YELM WA 98597
Property Information:
Site Address: 119 VII=I M AVF F
Assessor Parcel No.: 64400600500 Subdivision:
Contractor Information:
Name: UNCLE ROY'S MUSIC
Address:
PO BOX 2252
YELM WA 98597
Contractor License No.:
Project Information:
Project: PLUMBING
Description of Work:
NEW GAS SERVICE
Sq. Ft. per floor:
First
Second
Third
Garage
Basement
Fees:
Item
PLUMBING
Permit No.: 20120265
Issue Date: 9/05/2012
(Work must be completed within 180 days)
Phone: 360 - 400 -1100
Owner: RUTH PORTERFIELD
Phone:
Expires: 0 /00 /0000
Heat Type (Electric, Gas, Other):
Contractor
UNCLE ROY'S MUSIC
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 Iso certify that the proposed structure is in conformity with all applicable City of
Yelm regulations includ' g those governing zoning and land subdivision, and in addition, all covenants,
easements and restri ns of rd. If applying as a ntractor, I further certify that I am Curren) ly
registered in t� §tat of We gton. ,,� �� /
Lot:
Fees
$ 25.00
$ 25.00
OFFICIAL USE ONLY
# Sets of Prints:_
Final Inspection:
Date:
By:
City of Yell
(36 ) 458 -6402
REC #: 00104069 9/05/2012 12:57 PH
OPER: CO TERM: 001
REF #: 1007
TRAN: 33.0000 BUILDING PERMITS
20120265
UNCLE ROY'S MUSIC
112 YELM AVE E
PL 25.000R
TENDERED: 25,00 CHECK
APPLIED: 25.00 -
CHANGE:
CITY OF YELM 20 Z0
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: U S1) Parcel #:
• Zoning; Current Use: �L Proposed Use:
•
•
❑ New Construction ❑ Re -Model / Re -Roof / Tenant Improvement
Plumbing ❑ Mechanical ❑ Fire Prevent/Suppress /Alarm ❑ Other
Project Description /:
Project Value:
Building Area (sq. ft)
Building Height
of
EA
Parking Garage 151 Floor 2nd Floor 3rd Floor
Are there any environmentally sensitive areas located on the parcel? _
completed environmental checklist must accojnpany permit application.
BUILDING
If yes, a
1�1l1... 1 11LiiLSi ►��ae »:faaasli'.�►l ++= e_rtr��I
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 JFC).
I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the
above de bed property will be in accordance with the laws, rules and regulations of the State of Washington and the
City of Ye
_Z_
p icant's Signature Date
Owner/ Contractor/ Owner's Agent I 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
105 Yelm Avenue West
PO Box 479
Yelm, WA 98597
(360) 458 -3835 p 1 n
(360) 458 -3144 FAX
WWW.ci.yelm.Wa.as