20120277 Permit Pkg 09192012City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: MAULTSBY VANESSA
Address: PO BOX 211
RAINIER WA 98576
Property Information:
Site Address: And FIRST ST SF
Assessor Parcel No.: 22719332300 Subdivision:
Contractor Information:
Name: A AFFORDABLE PLUMBING CO.
Address:
8540 WILLIAMS PL SE
YELM WA 98597
Contractor License No.: AFFPRPC963JA
Project Information:
Project: PLUMBING
Description of Work:
INSTALL TWO SINKS
Sq. Ft. per floor:
First
Second
Third
Garage
Basement
Fees:
Item
PLUMBING
N/A
Permit No.: 20120277
Issue Date: 9/19/2012
(Work must be completed within 180 days)
Phone: 253 - 255 -3794
Owner: VANESSA MAULTSBY
Lot: N/A
Phone: 360 - 458 -9362
Expires: 4/01/2006
Heat Type (Electric, Gas, Other):
Contractor
A AFFORDABLE PLUMBING CO.
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 including those goveming zoning and land subdivision, and in addition, all covenants,
easements and restrictions of record. If applying as a contractor, I further certify that I am currently
registered yy��((he St a ington. 1
Sianature Date 1
Finn
Fees
$ 34.00
$ 34.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
SCANNtu
OCT 0 2 2012
City of Yelp
(36 ) 458 -8402
REC #: 00105939 9/19/2012 8:21 AM
OPER: CO TERM: 001
REF #: MC
TRAN: 33.0000 BUILDING PERMITS
20120277 34.000R
VANESSA, MAULTSBY
404 FIRST ST SE
PL 34.000R
TRAN: 30.0000 BUSINESS LICENSE
FRUITIAON SALON
BUSINESS LICENSES 8 35 -000R
TENDERED: 69.00 OTHER
APPLIED: 69.00-
CHANGE: 0.00
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: 1 C1 .1 113T '�;L S t�_ Parcel #:
Zoning; Current Use: Proposed Use:
U New Construction U Re -Model / Re -Roof / Tenant Improvement
VlPlumbing U Mechanical U Fire PreventtSuppress/Alarm U Other
Project Description/Scope of Work:
Project Value:_
Building Area (sq. ft) Parking Garage 1n Floor 2e° Floor 3" Floor_
Building Height
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER(TENANT NAME:
ADDRESS L \\ EMAIL
CITYQ, ,.,.,.i,er STATE ZIP TELEPHONE.), 2 -2-C 3i4N
ARCHITECT/ENGINEER LICENSE #
CITY
GENERAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTORS LICENSE # EXP DATE CITY LICENSE #
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTORS 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 (MC).
I hereby certify that the above IMwmation 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 Yelm.
Applicant's Signature Date
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 period of 180 days
105 Yelm Atrnue West (360) 458 -3835
PO BOX 479 (360) 458-3144 FAX
}elm, WA 98597 umm.ci.yelm.ua.ua