20080157 Demo Permit 05132008 o�T� Clty Of YelrYt Perrnit No: DEMO-08-0157-YL
r� � Community Development Department Issue Date: 05/13/2008
4 (Work must be started within 180 days)
Building Division
Phone:(360)458-8407 Receipt No: 54434
_, Fax:(360)458-3144
w.:�„wro�
Applicant:
Name: Wenshan Lee Phone: 206-683-5688
Address: PO Box 13253 City: Des Moines State: WA Zip 98198
Properly Information:
Site Address: 15905 90th SE
Assessor Parcel No. Subdivision: Lot:
Contractor Information:
Name: Contact: Phone:
Address: City: State: Zip:
Contractor License No: Expires: Business License:
Project Information:
Project: Wenshan Lee
Description of Work: Will move the house off current location
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: a50.00
ApplicanYs 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 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 Washingto�. Final(nspection:
. Date:
Signature -, _;. : . ---._.._.._.. Date �� - ' �^, -,a���
Firm BY�
q Q�THFA�9� City of Yelm
Permit Fees Schedule
4 � Community Development Department
~ Permit No: DEMO-08-0157-YL
Building Division
Phone:(360)458-8407
YELM Fax:(360)4583144
A+Pplicant:
Name: Wenshan Lee
Phone: 206-683-5688
Address: PO Box 13253 City: Des Moines
State: WA Zip 98198
Project Information:
Project:Wenshan Lee
Description of Work: Will move the house off current location
Site Address: 15905 90th SE Assessor Parcel No.
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: $50.00
. .. . : -• . • -• .
o�ftHEp� CITY OF� _ _ — �__.
d m YELM
P.o.Box 4�9 ��4 3 4
Yeim,wA 9ass� RECEIPT No.
YELM 360-4583244
RECEIVED �*��FI�''T� DC�LLAR� � Q�3 CEI�3TS
RECEIVED FROM DATE REC:N0. AMOUNT REF.NO.
61EAISH,AN I,EE 05J13I��' S4434 5��i3O£� CP.�H
F0 BQX 13253
DES tfOUIES ��lA 98?�� BUDGFTARX
159�5 ��TH �E DE��+�
t�fICH�LLE
., � -u>t -� ,.'� -i
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: P�`�G t� C�� ��� S�=- Parcel#:
,
Subdivision: Lot#: Zoning; ___���S�c`�:���l��i..�.
❑ New Construction ❑ Re-Model/Re-Roof/Addition ❑ Home Occupation Sign
❑ Plumbing o Mechanical ❑ Mobile/Manufactured Home Placement ❑ Other
Project Description/Scope ofWork: �,tV�`,��� �'1C�= �"������ �)c;i+�� C-�(— C:.�,,r►��,w��.l.�(��"�]G� i.
Project Value:
Building Area (sq.ft) 1St 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? ?v�,.� If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER NAME: ` s
ADDRESS � 0 �3c�c t3z�� EMAIL
CITY ��..s �Y?1os'r►.:�SSTATE�_ZIP � - " TELEPHONE �v�L -L� � - S G��
ARCHITECT/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 LICENSE#
MECHANtCAL CONTRACTOR TELEPHONE
ADDRE�S EIInA!L
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
Copy of mitigation agreement with Yelm Community Schools, if applicable.
I hereby certify that the above information 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. ?
i
(;s'-� ��-� =°J � - i 3-�JS'`
pplicant's Signatur �� 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
I05 Yelm Aaenue West (360)458-3835
PO Box 479 (360)458-3144 FAX
Yelm, WA 98597 www.ci.yelm.w¢.us