20130174 Permit Pkg 04152013 o City of Yelm Permit No.: 20130174
,� Community Development Department Issue Date: 4/15/2013
�' (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
`""�"""�`°" Fax: (360)458-3144
Applicant:
Name: KAI HOWARD Phone: 253-304-8433
Address: 614 TRUMP AVE NW
YELM WA 98597
Property Information:
Site Address: 614 TRUMP AVE NW Owner: KAI HOWARD
Assessor Parcel No.: Subdivision: Lot:
Contractor Information:
Name: KAI HOWARD Phone:
Address: KAI HOWARD
614 TRUMP AVE NW
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: RESIDENTIAL ADDITION
Description of Work: PATIO COVER
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
BUILDING KAI HOWARD $ 63.93
TOTAL FEES: $ 63.93
ApplicanYs Affidavit: OFFIGIAL USE QNLY '
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 #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 further certify that I am currently Final Inspection:
registered in the State ashi�
Signature • Date � ����� Qate:'
Firm _ By'
�
/
a
Cit� of Y�lm
(36 ) 45�-8402
�EC#� UC1125360 4%16/�t�13 1 :02 f�M
OpER; CO TERM: OQ1
REF#: LAM
T�tAN: �33,OOOl1 BUTLDING F?EF�MCTS
2Q1301�14 ��.����
HqWARD, KAI
614 T�UMP AVE NW
BLDG fi�.�3CR
TENDE��E�: 63.93 Ol I�ER
APPLIED: 63.53-
CHA NG E: .___.____.w..-_�.00
-��'���3 -�' �`"(
CITY OF YELM
RESIDENTIAL BUILDlNG PERMIT APPLtCATION FORM
Project Address: (D� 1 �m f"�� 1 vU� Parcel#:
Subdivision: Lat#: Plan#: 2oning:
�New Construction _� Re-Model/Re-Roof/Addition ❑ Home Occupation Sign
❑ Plumbing � Mechanical i_ Mobile/Manufactured Home PEacement � Other
Project DescriptioNScope of Work: ��`«' �o i!�(Z ���r '� �3��
Projectvalue: � ��O O
Building Area(sq.ft} 1�`F[oor 2nd Floor Garage Deck
Basement Carport Patio cZ�S S`���'
#Bedrooms_ #Bathrooms� Heating: GAS/OTHER or ELECTRIC(Circle One)
Are there any environmental{y sensitive areas located on the parcel?
!f yes,a completed environmental checkEist must accompany permi#application.
B.UILD[N'G<;O1IVNEJ;�;IVA�IUiE: C
ADDRESS 1 � i..VY`� `2 N EMAIL , `�Ctl�j2 �,�'1'r' C�t�'1Gll�
CIlY_„Y� �_STATE tt114 ZIP a fi� __ �- TELEPHONE a.i3-3ati-$`f�3
AREHITE,�T/EN;GINEER UCENSE#
ADDRESS EMAIL
CITY STATE ZlP TELEPHONE
�EN�RAL GONTRACT�F2 TELEPH4NE
ADDRESS � EMAIL
CITY STATE ZIP FAX
CON7RACTOR'S LICENSE# EXP DATE CITY LICENSE#
PLUM$IN���(�'RAC`�"Ql� TELEPHONE
ADDRESS EMAlL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXf' DA7E CITY UCENSE#
-r:........r�..._.. . .. .
M��CfiH.:N;,,[C,AL::Cf3,N7f�1�TQ;R TELEPHONE
ADDRESS EMA1L
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
Copy of mitigation agreement with Yelm Community Schools, if applicable.
1 hereby certlfy that the above 3nformation is correct and that the constructlon on,and the occupancy and the use of the
above described property witl be in accordance '�e laws,rules and regulations ofthe State of Washfngton and the
City of Yelm.
!�/�
Applican s ' nature Date
Owner 1 ontractor 1 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 Auenue West (360)458-3835
XeIm,WA 98597 (360}45�3Y44 FAX
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