20050730 Demo Permit 09282006 o�T� Clty Of Yelm Permit►vo: BLD-05-0730-YL
� � Community Development Department Issue Date: 09/28/2006
� (Work must be started within 180 days)
Building Division
Phone:(360)458-8407 Receipt No: 43896
_, Fax:(360)458-3144
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Applicant:
Name: Welis,Sara Phone: 360.455.0694
Address: 8210 Eagle Ridge Lane SE City: Olympia State: WA Zip 98513
Property Information:
Site Address: 15911 90th Avenue SE
Assessor Parcel No. 00000000000 Subdivision: Lot:
Coritractor Infortnation:
Name: Contact: Phone:
Address: City: State: Zip:
Contractor License No: Expires: Business License:
Project Information:
Project: Wells Demo
Description of Work: Move home from city lot out of the City-to tribal land
Sq.Ft.perfloor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0
Heat Type(Electric,Gas,Other):
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
-------------------------- ----------- ----------- ----------- ----------- ----------- -------------
Building Permit-Other 50.00 0.00 0.00 0.0000 0.0000 $1,000
TOTAL FEES: $50.00
Appiicar►Ys AfFadavit:
I certify that I have read and examined the information contained within the application and know the same OFFICIAL USE ONLY
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of #Sets of PciMs:
Yelm regulations including those governing zoning and land subdivision,and in addition,all covenants,
easements and trictions of record. If app m as a contractor, I futher certify that I am currently
registered in t e S ate of Washington. Final Inspec�on:
�
Signature �% Date �L%� J Date:
Firm �y"
• �• � � � � '�• `� •� -
o�.�f T"�� CITY OF
d YELM
YePm,WA 98597 RECEIPT NO.
360-458-8403 4 3 8 9 5
RECEIVED
****FIFTY DOLLARS & 00 CENTS
RECEIVED FROM DATE REC.NO. AMOUNT REF.NO.
SARA GfELL3 09/28/06 43895 50.00 CHECK 5571
8210 �AGLE RIDGE LANE SE
OLHPIA NA 98513 BUDGETARY
JANINE
BLD-05-0731-YL
SITE 15907 90TH AVE SE
- -- -- -- - � .. . : -. . . -. .
��f T� CITY OF �
� �''� YELM �'
4
YePm,WA 98 97 RECE � Wa.�4 3 8 9 6
360-458-8403 '
� RECEIVED � � �
****FIFTY DOLLARS & 00 CENTS - '
RECEIVED FROM • DATE REC.NO. AMOUNT REF.NO.
SARA NSLLS 09/28/06 43896 50.00 CHECK 5571
8210 EAGLE RIDGE LANS SE
OLYMPIA NA 98513 BUDGETARY
JANINE
BLD-05-0730-YL
SITE 15911 90TH AVE SE
. .. . : -. . . -. .
���T"� CITY OF
� � YELM
YePm,WA 98597 RECEIPT NO.
360-458-8403 4 3 8 9 7
RECEIVED
***"`FIFTY DOLLARS & 00 CENTS
RECEIVED FROM DATE REC.NO. AMOUNT REF.NO.
SAAA KELL3 09/28/06 43897 . 50.00 CHECH 5571
821� EAGLE RIDGE LANE SE
OLYNPIA NA 98513 BUDGETARY
JAN NE
BLD 05-0729-YL
SITE 15913 90TH AVE SE
T City of Yelm ��`��� Permit Fees Schedule
��F �p
� � Community Development Department ;��S, � � !'t ii l, Permit No: BLD-05-0730-YL
d �A
Building Division
Phone:(360)458-8407 �,;���V (��"' ����.�`�t
YEL Fax:(360)458-3144 ��� (jG��
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Applicant:
Name: Wells,Sara Phone: 360.455.0694
Address: 8210 Eagle Ridge Lane SE City: Olympia State: WA Zip 98513
Project Information:
Project:Wells Demo
Description of Work: Move home from city lot out of the City-to tribal land
Site Address: 15911 90th Avenue SE Assessor Parcel No. 00000000000
Fees:
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Building Permit-Other 032 001-322-10-00 50.00 0.00 0.00 0.0000 0.0000 $1,000
TOTAL FEES: 550.00
CITY OF YELM �
RESIDENTIAL BUILDING PERMIT APPLiCATION FORM ;, �.
.��' €��� � t��;�-;
Project Address ��`"1 � I ���lH V��, Parcel#:s�'�Q `1 �
�EP 18 ?(!Of �
Subdivision: Lot#: Zoning; ��
U New Construction u Re-Model/Re-Roof/Addition u Home Occupation Sign
u Plumbing u Mechanical u Mobile/M n ctured Home Placement u Other
�
Project DescriptioNScope of Work:
Project Value:
Building Area (sq. ft) 1�`Floor�� 2"d Floor Garage Deck
Basement Carport Patio
#Bedrooms� #Bathrooms� Heating:GAS/OTHER or ELECTRIC(Circle One)
Are there any environmentally sensitive areas located on the parcel? If yes,a
completed environmental chec ist must accompa y permit pplication.
BUILDING � E: " �
ADDR S ' A L
CITY L �' ST TE TELEPH
ARCHI CT/ENGINEER LICENSE#
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR TELEPHONE
� ADDRESS EMAIL
'� CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
�
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY UCENSE#
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
Copy of mitigation agreement with Yelm Communiry Schools, if applicable.
I here rtify tF�at the above 1 atfon is correct and that the construction on,and the occupancy and the use of the
abo dea�cribed property wil in ccordance wkh the laws,rulea and regulaUons of the State of Washington and ffie
City f Y}tym. , -, �
`" , � �?
��. .,
,,
pplicant's Signature Date
Owner/Contractor/Owner's Agent/Contractor's Agent (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 Auenue Weat (360)458-3835
PO Box 479 (360)45&3144 FAX
Yelm, WA 98597 wrvro.ci.yelm.wa.ua