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20130365 Permit Pkg 12162013 �'`�p� tHEp�� Clty of Yelm Permit ►vo.: 20130365 . o � a � Community Development Department Issue Date: 12/16/2013 (Work must be completed within 180 days) Building Division Phone: (360)458-8407 YELM Fax: (360)458-3144 Applicant: Name: YELM PROPERTY DEVELOPMENT Phone: 360-458-0544 Address: P O BOX 2950 YELM WA 98597 Property Information: Site Address: 16669 GREENLEAF AVE SE Owner: YELM PROPERTY DEVELOPMENT Assessor Parcel No.: 84070010000 Subdivision: WILLOW GLENN Lot: 100 Contractor Information: Name: YELM PROPERTY DEVELOPMENT Phone: 458-0544 Address: DENNY BALASCIO P O BOX 2950 YELM WA 98597 Contractor License No.: YELMPDL00302000 Expires: 2/20/2011 Project Information: Project: NEW RESIDENTIAL BUILDING Description of Work: LOT 100, PLAN 2565J Sq. Ft. per floor: First 955 Heat Type(Electric, Gas, Other): GAS Second 1241 Third Garage 393 Basement Fees: Item Contractor Fees NEW RESIDENTIAL BUILDING YELM PROPERTY DEVELOPMENT $16,754.37 MECHANICAL SUNSETAIR INC $ 71.75 PLUMBING TOP NOTCH PLUMBING INC $ 118.00 TOTAL FEES: $16,944.12 ApplicanYs 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 in the State of hington. Signature ,�� �. C Li.c� Date /��/G�2oJ3 Date: Firm By� _ Cit� of Y�lm (36 } 458-8402 REC#; 00146928 12/16/2013 11 ;25 AM OPER: CO TE�M; 001 REF#: 6466 TRAN: 33,OOQ0 BUILDING PERMITS 20130365 16,944,12CR YELM PRUPERTY DEVEI.OPMENT " 16569 GREENLEAF AVE SE BLD-RESt 16,754.37CR MECH 71 .75CR PL 118.00CR TENQERED: 16,944.12 CHECK APPLIED; 16,944.12- CHANGE; 0.00 YELM CPOMBpXT4��GH00LS YELM WA 98597 Clerk: Croy Terminal : 1 Recei pt; 233987(Reprint) Manual Receipt; YELM PROPERTY YELM PROPERTY YELM PROPERTY, QEVEL�PMENT LLC , 12J16/2013 11 ,13 AM p�� Item _��_ _�.__�..___.___Price � CPF MITIGATION ��'�.'�0 MITIGATION 07-015/LQT 1Q0/16669 GREENLEAF AVE SE;YE Subtotal : ���p;00 Tax; 3015.00 Total; Check 3�15.00 6465 Change que: 0�00 R�PRINT RECEIPT TNANK YOU CITY OF YELM ' "�� ��y'� � RESIDENTIAL BUILDING PERMIT APPLICATION FORM Pruject Address: ����� C��En���+���� ���. Parcel#: Subdivision:��.lt1��j Lot#: OQ Zoning; ��l� � New Construction ❑ Re-Model/Re-Roof/Addition ❑ Home Occupation Sign ❑ Plumbing ❑ Mechanical o Mobile/Manufactured Home Placement ❑ Other Project Description/Scope of Work: � �l� I !�"� ��`��su Project Value: �ZG�, L7�� ,�,�� L� �� Building Area(sq. ft) 1St Floor 95s 2nd Floor /Z y/ Garage 3 1,3 Deck ., Basement '��l���r��:-1' �.��'cn^��G �b Patio �'���' �� ��%�G �� � n_,J # Bedrooms� � �Bathrooms�� Heating GAS/OTHE r ELECTRIC (Circle One) Are there any environmentally sensitive areas located on the parcel? � If yes, a completed environmental checklist must accompany permit application. SIJI�.DING 4WNER NAME: e w� ��c +� � r':�'e ':.a'�c " � ADDRESS o � EMAIL CITY ��' Wt.. STATE ZIP S TELEPHONE �SS �a � ARGy1TECT/�,NGWEER�o � �. - LICENSE# ADDRESS U` a +'zrn r� EMAIL CITY �it e(. STATE�ZIP ' -" TELEPHONE 3 � /Z W7o-i GEN�RAL CONTRAGTOR �.. TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE# PLiJMBING C�NTRACTOR n C TELEPHONE a��.' ' ADDRES S ,."�4' �''`�� EMAIL CITY�crtfl�Q'r" STATE�_ZIP `?.� � FAX CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE# 11AECHANICAL GONTRACTOR " TELEPHONE 'S��a�" ` '%�'� ADDRESS Z�C� AG� �V EMAIL CITY L�L�E� STA E ZIP .��'C' FAX CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE# Copy of mitigation agreement with Yelm Community Schools, if applicable. 1 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 1'elm. � �'1�1 ` �i � i� Jl Applicant's Signatu Date Owner 1 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 I —I __ .� � I05 Yelm Auenue West (360)458-3835 PO Box 479 (360)458-3I44 FAX Yelm, WA 98597 www.ci.yelm.wa.us _ CI�/ r�� 1�'��t'1''1, CL.)C) :��:.._. �p�r��r�d o l �- —` �t— � � �....;.�:..�..��� _ _ . __. .._..�Gc�ente�' .�?!�,re,...,..5�_.._.__ Wa�e� �cr 6 �C DfGµrlo �«+��, ._...._._.,r_ .. �� _ eX � ____. ._._..__.. ����_,_.__ __.�.�.... , ��t� � � S� .,, �. •` �� � S;duW�7lC '"` •. __.__ r �,�_.�;,�. p��� � , , r � � �,� ! 1 ro �. ,..__� � . E94'eMe„ r _i ; _ _ _ ... _ _� _ ` _.. _ � _ ��� ., f N � —`� . Q .�- � t'����h f � i - _.. `�! 'L ,�l�7.Z!�1 � � _. _: _ __ ._ � �'+o�►"`�.� 1 _a:� �„ � ,� + c�+.��Lf .Sx�.���w`,+r�: ti ��.,�. , 1 ____ .. � �°"` , Gra r. ; 1 � ��� a i ` ' �; Si-�M--B(o=- � ` � // Yc".o, � r � ' � SG.�e - � = ZO � t '1�, ��a ; `'=� ... 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