20070385 Demo Permit 10232007 �pF THFp City of Yelm Perrnit►vo: DEMO-07-0385-YL
.� � Community Development Department Issue Date: 10/23/2007
d � (Work must be started within 180 days)
Building Division
Phone:(360)458-8407 Receipt No: 50798
YELM Fax:(360)458-3144
Applicant:
Name: 3B8C,LLC Phone: 360-894-2296
Address: P.O.Box 875 City: Yelm State: WA Zip 98597
Property Information:
Site Address: 10336 West Road SE
Assessor Parcel No. 64303601701 Subdivision: Lot:
Contractor Information:
Name: Applicant Contact: Phone:
Address: City: State: Zip:
Contractor License No: Expires: Business License:
Project Information: _
Project: West Road Professional
Description of Work: Demo Permit for existing House
Sq. Ft.perfloor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0
Heat Type(Electric,Gas,Other): 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: $50.00
ApplicanYs Affadavit:
I certify that I have read and examined the information contained within the application and know the same OFFICIAL U5E QNLY
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints:
Yelm regulations including those governing zoning and land subdivision,and in addition,all covenants,
easements and restrictions of record. If applying as a contractor, I futher certify that I am currently !
registered in the State of Washington. Final tnspection:
Signatur / ate /� , 2�. U ^} Date:
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Firm �� �e �C_ °� _ __ —__ _ _ �y�
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��y�"�l �YE �F
LM
P.O. Box 479 f ,
Yelm, WA 98597 RECEIPT No. �� ��$
YELM 360-458-3244
RECEIVED �*�*EIFTY DOLLARS & 00 CENTS
RECEIVED FROM DATE REC.NO. AMOUNT REF.NO.
3 B & C, LLC 10/23/07 50798 50. 00 CHECK
PO BOX 875
YELM, WA 98597 BUDGETARY
360-894-2296
10336 WEST ROAD SE
LORI
DEMO-07-0385-YL DEMO PERMIT FOR EXISTING HOUSE
WEST ROAD PROJECT
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� Olympla, WA 985Q2
� (360) 58�-1044 or 1-8QQ-4�2-5623
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�,�,��,,�{ �.��h.�' ��x: (36t7) 491-6308 � www.�RCP►P►.org
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� Nc��l�i�ation af Demali#�,an Pexznit �
lt fs utttarvfal for 3iny person to cauee Or allava the demolition (ar major res�ovntion) of acry strUctare unless a11�beetoe�
�vntAlning tnstorim�have been rPmo��ed SYom tl�e nrca to ba ci4malisla��J. Wor1e aliall not corr�mence on un A�beeiao pro�eet
or dea�colition anl�s the owoeY ar oparntor has obtalnec� wrtttep npprArnl fra�n ORCAA. A wrlttcn appllcahon for a
dcnreoNtlon shAll Itneiude a eertiffentlon #hnt there ta no Icnvwn a�beatoa-conlaEntng mater[at nmRlning ta the Aren of tba
stivcture. j G�lu1 �e.�J�e..
Project S ite Add�ess; /0 3'3'� +s'� �t-"��""r"� , � ��
City:r„�Y��ts�^2, � _ Stete: �/g _�Zip
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Startin�I)ate: ['��r. /� C�7 �ai�pletion Z7ate:_�,, /
'�{Thtre is a 10 worl�ing day�nce notification periad from recoipt af ponnit appfio�teon)
Property Owner:;�.��t� � Telephon�:��✓.��f� �'ax:�
Mailing Address�?r'� �••� �"�'� �
Ciiy, c � State; c.�?,�. -,�?ip�,.�'s�..�'
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Domolitton Con�actor: tJu+,+v�� 5tstc Llcense#:�,
Ma[Ilnp,Address:{•n•s.�•n /-,7t .<J.�+�._._�— —
�ity: State� � Zip:
Contaot 1'erson:,�„�',�c���- r����.Rx..,a TeloplloMe:� � Fax�!�
Y'�S N�0 - - - � '�'��—�v�d�
�/� ! Demolition by Wrecking ar Dism�ntling7 ($25.00 fc�)cheol: ,_no��e�undab�e
_ _� r�ining Fire Demolition? (ffyes, attach fire d�paxCrt�ent t�e��uest for training fire)
�enowatian,Alteratian= I��madeling, Maint� �nae, ar oth�r Con�sfiructfon?
�~ � Adbestoe fo�nd or snspect�rl* ,�7�,�
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*An ORCAA "Ploti�c ai'Intce�e m Re�rtove or Encupaul�te,\sbcdtOa" C�nn pn�1 �pproprinta fee enuet I�e subml¢ed Prior to uny asbesl�s
r+emavaf worlc, •qgbtlatos rpmov4t prolaot� Involving domolitiom m�st be profo�m�d by s Catifiad Aebcatoe C�ntt�atdt'p�d �11 �lebie qr
paFsn�laily friabie as�sestos musi be remo�+ed beibrt ony demolltion begles. Reihr to QACAA Itegula6an I ,0.rrlcle 14 for addilior►al
requirametata that may�appty. .
� Asbe,to� Survey Completetl b�r �
A�iERA,Cerkifi�ed Inapeett►r �S��,� �S'�' ,�'�iJ�►-S'� •�.c�'�� �
�ertifia�tio�n# �o�.�' - , ��
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Tttis epprorad permit muat Enclpse$23 Certifiagsi��n oftl�e As6estns Suzve�y must
be�valleble et�e job siu� � �+t'oeeA��ng Fee accomparry tl'�is�ferm
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