20070135 Permit Pkg Plumbing 01132014 '�`�'o� T"�p,p`�," City of Yelm Permit ►vo.: 20070135
� '
� � Community Development Department Issue Date: 10/30/2013
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
LM
""'"`"'"`�°" Fax: (360)458-3144
Applicant:
Name: YELM DENTAL CLINIC Phone:
Address: 502 YELM AVENUE WEST
YELM WA 98597
Property Information:
Site,4ddress: 502 YELM AVE W Owner: YELM DENTAL CLINIC
Assessor Parcel No.: 21724142200 Subdivision: Lot:
Contractor Information:
Name: YELM DENTAL CLINIC Phone:
Address: JUDD SHERMAN
502 YELM AVENUE WEST
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: TODAY'S DENTAL
Description of Work: Demo existing 2 buildings on 2 parcels, new 4530 sf dental office w/p arking, site devel, street
frontage improvements 3/29/2007-TM Received application. File ID'SPR-07-0135-YL', Case#_
1526
Sq. Ft. per floor: First Heat Type(Electric,Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
PLUMBING YELM DENTAL CLINIC 1/13/2014 ~ $ 167.00
SITE YELM DENTAL CLINIC $ 750.00
NEW COMMERCIAL BUILDING YELM DENTAL CLINIC $17,807.03
TOTAL FEES: $18,724.03
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 ceRify that I am currently Final Inspection:
registered in the State of Washington.
Signature � �/����j�,��, Date � .. � 3 ��� Date:
Firm By�
Cit� of Y�lm
(36 ) 458-8402
REC#: 00149141 1/13/2014 1:35 PM
OPER: Cp TERM: 001
REF#: 1387
TRAN: 33.0000 BUILqING PERMITS
20070135 167.00CR
YELM DENTAL CLINIC
502 YELM AVE W
P� 167,OOCR
TENQERED: 167.00 CHECK
APPLIED: 167.00-
CHANGE: 0.00
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