20140160 Permit Pkg 05062014 'f��pF T��p,��' City of Yelm Permit No.: 20140160
,
� � Community Development Department Issue Date: 5/06/2014
� en (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
EL
"".°"'""Q" Fax: (360)458-3144
Applicant:
Name: MT TERRACE BUILDERS Phone: 360-458-1502
Address: 14730 STATE RT 507
YELM WA 98597
Property Information:
site Address: 10004 TYLEAH CT SE Owner: MT TERRACE BUILDERS
Assessor Parcel No.: 47130000500 Subdivision: FAIRWAY ESTATES Lot: 5
Contractor Information:
Name: MT TERRACE BUILDERS Phone:
Address:
14730 STATE RT 507
YELM WA 98597
Contractor License No.: Expires: 0/00l0000
Project Information:
Project: NEW RESIDENTIAL BUILDING
Description of Work: LOT 5, PLAN 2589M
Sq. Ft. per floor: First 1137 Heat Type (Electric,Gas, Other): GAS
Second 1508
Third
Garage 611
Basement
Fees:
Item Contractor Fees
NEW RESIDENTIAL BUILDING MT TERRACE BUILDERS $17,763.02
MECHANICAL BEST CHOICE HEATING $ �8.25
PLUMBING JR'S PLUMBING $ 125.00
TOTAL FEES: $17,966.27
ApplicanYs Affidavit: OFFICIAL USE ONLY
I certify that I have read and examined the information contained within the application and know the same
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints:
Yelm regulations including those governing zoning and land subdivision,and in addition,all covenants,
easements and restrictions of record. If applying as a contractor, I further certify that I am currently Final Inspection:
registered in the State ashington.
� 1 Date:
Sign ture Date
By:
Fi
Cit� of Y�lm
�36 ) 458-8402
REC#: 00159932 5/06/2014 1;47 PM
OPER: CO TERM: 001
REF#; 23374
TRAN: 33.00U0 BUILDING PERMITS
20140160 17,966.27CR
MT tERRACE BUILDERS
10004 TYLEpH CT SE
BLD-RES1 17,763.02CR
MECH 7$,25CR
P� 125.00CR
TENDEREQ; 17,966.27 CHECK
APPLIED: 17,956.27-
CHANGE: 0.00
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CITY OF YELM �`�O` ��
RESfDENT1AL BUiL01NG PERMIT APPLlCATION FORM
Project Address:_ 1�(jC�� c�.,�,� parce�#: �-1�-I 3 C�U00 j C�O
_ Subciivision�_�r4t{c..�t� l.ot#:�u Plan #: 2.`7 � VI� Zoning:
�1ew Construction Re-Model/ Re-Ronf/Addition Home Occ�patipn Sign
Piumbing ' Mechanical ` Mobile/Manufactured Home Placement Other
Project Description/Scope of Work:__���_Cp�'\S-��v�,��
wr�ject va�ue� � i �� Cx,r-� �'° �ZO,�
Building Area (sq. ft) 1" Flaar� 2a° Floor (. U 3`d Floor Garage-2 car 3 car��
Covered Patia � Covered Porch Patio Deck
#Bedrooms� # Bathrooms Zt�Z Heatin : GAS/ TWER or ELECTRIC (Circle (Jne)
Are there any enviranmentaEly sensitive areas located on the parcel? � _
If yes, a completed environmental checklist must accompany permit applicatian
�_...._.___._.._.___.m_.._-------_...______.._.____.._�_�._.__.._ ...,.__.___
_, _....._.._ _....___.__.,....,.__ ._._._,_._�_..�.._. . _.._._.____
; BUILDlNG OWNER NAME. 4'Y�Z� LL.L
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f ADDRESS_ �UI`�,�c:� ,`_>"C �.� 5u� EMAIL ��t�f r�..�...�,.�t ,�,� -�� �c °�-
� CITY Y�l�� STATE �.-*a� ZIP '�'I'£'3��- TE�EPHONE •�r�'�" .
E ADDR ESS �U'�+�--_..___._..____ .._.._..� ___.. . -----._...__W. ._. _.. __ _.__ ___ __ __...___.
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P ARCHI7ECT/ENGINEER_��'D LICENSE #
, _'�� S� �C-.._� EMAIL —_.
j GTY ��kaa,.,.:�c�c STATE �--'� ZIP ���`i`� TELEPHONE Z� � 5'���-( -Lc� t:i
-- _...�w_.___._.._ _��...,. __.._.. ._____ ___._......._.._____ . ..._...._ ____.... ,.,—-..
d GENERAL CONIRAGTOR � 4 J ��
� TEI.EPHONE
i ADORESS � �"T T `�- EMAtI. ��� �� SC Z ,c c.�.cr
"�" f CITY STAT'E�_�ZIP Fq}(
', CONTRACTOR'S LICENSE #�QL�? �'j��j�� EXP DATE� `CITY LiCENSE #
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� PLUM6ING CONTRACTOR _ .�.c. TE�EPHONE �3 ��f, Z��t 7
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� ADDRESS i � EMAIL ,,�:,0��' � 1,��',
! C1TY `ti�.,l� STATE w�t ZIP �3{.�'�1�' FAX ���«,
� CONTRACTOR'S LICENSE #�QS�(_.z�r��7��`�15 EXP OATE-� CtTY LICENSE #
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' MECHANICAL CONTRACTOR ��_C�, ,��,��_ TELEPHONEm 'L,j � �3``� - tr �t'J����"���
' ADDRESS i 2.LPG%`c.".� �`�''-� ,�,_ac„ � EMAlI. �c�.'1. h��� ' �. ��,j:--- --�- �'�T
jCITY"+'c..��.�,�..�. STATE�iJ�� ZIP �-ILv FAX �
CONTRACTOR'S LICENSE #{"���sC.C`tS�;�� �XP DATE3/��..�CITY LICENSE #
___ Copy of mitigation agreement with Yelm Community Schaols, if applicahle.
I hereby certlfy thai 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 Stat�af Washington and ihe
City oi Y@Im. ��f
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Appl�cant's Signature �,
Owner I Contractor t Qwner's Agent/Contractor's Agent (Please circle one.)
All permits are non-t�ansferable and witt expire if work authorized by such permit is not begun
wiihin 180 days of issuance, or if wark is suspended or abandoned for a p�riod of 180 days
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