20130321 Permit Pkt 09162013 �pF �H�p� City of Yelm Permit No.: 20130321
V 'r
� �, Community Development Department Issue Date: 9/06/2013
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
L
`""`"'""°" Fax: (360)458-3144
Applicant:
Name: STEPHANIE/JOE KANGISER Phone: 253-686-4464
Address: P.O. BOX 1745
YELM. WA 98597
Property Information:
site Address: 10326 PARKVIEW LP SE Owner: JOE KANGISER
Assessor Parcel No.: 67290002700 Subdivision: Lot:
Contractor Information:
Name: STEPHANIE/JOE KANGISER Phone:
Address:
P.O. BOX 1745
YELM. WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: RESIDENTIAL REMODEL
Description of Work: INSTALL WINDOW
Sq. Ft. per floor: First Heat Type(Electric,Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
BUILDING STEPHANIE/JOE KANGISER $ 38.75
TOTAL FEES: $ 38.75
Applicant's Affidavit: OFFICIAL USE ONLY
I certify that I have read and examin d the information contained within the application and know the same
to be true and correct. I also certify at the proposed structure is in conformity with all applicable City of #Sets of Prints:
Yelm regulati ns including those g erning zoning and land subdivision, and in addition,all covenants,
easements a restrictions of rec� . If applying as a contractor, I further certify that�am currently Final Inspection:
registered in State of Washin on. ` --
Signature Date �t C ^ � Date:
Firm
By:
Cit� of Y�lm
(3G } 458-8402
REC#: 00137689 9/06/2013 9:46 AM
ppER; CO TERM; 001
REF#:
TRAN; 33.t1000 BUILDI38.75CRITS
201�U321
KANGISER, STEPHANIEJJOE
10326 PARKVIEW �8 �5CR
BLDG
T��p�REp; 40.00 CASH
APPLIED: 38.75-
CHANGE: 1.25
Zo►�� ;�
CITY OF YELM
____�—
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
� Project Address: /�J L-� 9�t�I�i�y���,� ��'��� Parcel#:
Subdivision: Lot#: Plan#: Zoning:
❑ New Construction ❑ Re-Model/ Re-Roof/Addition ❑ Home Occupation Sign
❑ Plumbing ❑ Mechanical ❑ Mobile/ Manufactured Home Placement ❑ Other
Project Description/Scop�Q Work: C r� � 1(,��� i�i �C�t �
Project Value: �d
Building Area (sq. ft) 1St Floor 2"d Floor 3�d Floor Garage-2 car 3 car
Covered Patio Covered Porch Patio Deck
# Bedrooms_ # Bathrooms_ 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 OWN�,R A : e S� O.II �
ADDRE$S L� � C � � a EMAIL y .Cdl'�� �
CITY � � STATE ZIP TELEPH NE , - ' .SS'-(�'6 ��'
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#
MECHANICAL 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 ertify that the above information is correct and that the construction on,and the occupancy and the use of the
above d scribed property will be in accordanc ' h the laws,rules and regulations of the State of Washington and the
City of elm.
C��,� S��'�D 1 3
Appl n Signatu Date
Own /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
�br
105 Yelm Auenue West (360)458-3835
Yelm, WA 98597 (360)458-3144 FAX
www.ci.yelm.wa.us