20110215 Permit Pkg 09232013 ��Q� TH�A�� City of Yelm Permit ►vo.: 20110215
7
� �'i,! Community Development Department Issue Date: 9/23/2013
� �
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
YELM
'""°" Fax: (360)458-3144
Applicant:
Name: RHONDA NORDEOFF Phone: 719-640-6379
Address: 10023 COCHRANE AVE SE
YELM WA 98597
Property Information:
Site Address: 10023 COCHRANE AVE SE Owner: BRYON NORDEOFF
Assessor Parcel No.: 56510001500 Subdivision: JOHN'S MEADOWS Lot: 15
Contractor Information:
Name: RHONDA NORDEOFF Phone:
Address:
10023 COCHRANE AVE SE
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: RESIDENTIAL ADDITION
Description of Work: PORCH AND DECK ADDITION
Sq. Ft. per floor: First Heat Type(Electric,Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
BUILDING RHONDA NORDEOFF $ 137.36
TOTAL FEES: $ 137.36
Applicant's Affidavit: OFFICIAL USE ONLY
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.,ir�.She�ate-e#V1fas#�iagtpnr--=-""—� ��
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Si nature,=� ' --�` - �� � Date:
9 � ; � Date•u---
Firm - � =� -- � By�
Cit� of Y�lm
(36 ) 456-8402
REC#: 00139559 9/23/2013 9:44 AM
OPER: CO TERM: 001
REF#: MC
TRAN: 33.0000 BUTLDING PERMITS
20110215 137.36CR
NORDEQFF, RHONDA
10023 COCHRANE AVE SE
g�p� 137.36CR
TENDERED: 137,36 OTHER
APPLIED: 137.36-
CHANGE: 0.00
i 2�� � z,r �J
�
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
� `r-
Project Address:i�G� C�(.�1�Yt� �V�» Parcel#: SISJ �� l�
Subdivision: Lot#: Plan#: Zoning:
� New Construction '� Re-Model/Re-Roof/Addition � ' Home Occupation Sign
' Plumbing Mechanical � Mobile/Manufactured Home Placement � ' Other
Project Description/Scope of Work: �d {�(,� �}-�t'C��
Project Value� ��(�b
Building Area(sq. ft) 1S` Floor"77l/ 2"d Floor Garage Deck
Basement Carport Patio
#Bedrooms� #Bathroom� Heating: GAS/OTHER or ELECTRIC(Circle One)
Are there any environmentally sensitive areas located on the parcel?
/fyes, a completed environmental checklist must accompany permit application.
BUILDING OWNER NAME: �
ADDRESS c� 0'�3 Co v� EMAIL S '�c7C�
CITY STATE ZIP TELEPHONE -(.o S'
ARCHITECT/ENGINEER LICENSE#
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERALCONTRACTOR 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#
MECHANICA�CONTRACTOR TELEPHONE
ADDRESS EMAIL
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.
�
Applicant's Si ture Date
Owner/Co ractor/ ner's A /Contractor's Agent(Please circle one.)
All pe mits 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 West (360)458-3835
Yelm,WA 98597 (360)458-3144 FAX
www.ci.yelm.wa.us
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