20130102 Permit Pkg 01092013 o�e City of Yelm Permit No.: 20130102
,� Community Development Department Issue Date: 1/09/2013
� (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
""" '°" Fax: (360)458-3144
Applicant:
Name: SHEA CARR JEWELL Phone: 360-352-1465
Address: 2102H CARRIAGE DR SW
OLYMPIA WA 98502
Property Information:
Site Address: EAST SR 507 Owner:
Assessor Parcel No.: Subdivision: Lot:
Contractor Information:
Name: SHEA CARR JEWELL Phone:
Address:
2102H CARRIAGE DR SW
OLYMPIA WA 98502
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: EAST GATEWAY
Description of Work: EAST GATEWAY ENVIRONMENTAL IMPACT STATEMENT EIS
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
ENVIRONMENTAL SHEA CARR JEWELL $ 750.00
TOTAL FEES: $ 750.00
C�t� Of Y�lm
(36 i �15�-84U2 OFFICIAL USE ONLY
nformation contained within the application and know the same
proposed structure is in conformity with all applicable City of
�'�.�#: (�1.11��J57b 1��9��a 1� �(�;1 U AM Zoning and land subdivision,and in addition,all covenants, #Sets of Prints:
oN��: Cn T��M; �I�� lying as a contractor, I further certify that I am currently
I�EF�: 3578 Final Inspection:
-fRAN� 3,�.U0(�0 BUIL.DINC F'E��MITS
Date Date:
2i)1301Q2 75U.00CR By�
SHEA CARR JEWEI.I.
SR 507
FNV 750.00CR
TENDEf�ED: ?50.0a CNEI,k
APPLIED; �50.00
CNANGE; ------_�_ 0.00