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20140190 Permit Pkg 06132014 . '��,o� T"�p�,�. City of Yelm Permit ►vo.: 20140190 � � Community Development Department Issue Date: 6/13/2014 (Work must be completed within 180 days) Building Division Phone: (360)458-8407 L `".""'"`T°" Fax: (360)458-3144 Applicant: Name: SAM MCGEE Phone: 369-960-8621 Address: 15314 104TH WAY SE YELM WA 98597 Property Information: site,4ddress: 15314 104TH WAY SE Owner: TYPE CURRENT OWNER NAME Assessor Parcel No.: 62320003800 Subdivision: MILL POND Lot: 38 Contractor Information: Name: BRIGGS CONTRACTING Phone: Address: PO BOX 1874 YELM WA 98597 Contractor License No.: BRIGGC1948CH Expires: 2/08/2016 Project Information: Project: RESIDENTIAL ADDITION Description of Work: Sq. Ft. per floor: First Heat Type(Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor Fees BUILDING BRIGGS CONTRACTING $ 137.36 TOTAL FEES: $ 137.36 ApplicanYs Affidavit: I certify that I have read and examined the information contained within the application and know the same OFFICIAL USE ONLY 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 zoni and land subdivision,and in addition, all covenants, easements and restrictions of record. If ap g as a contractor, I further certify that I am currently registered in the State of Washington j Final Inspection: % Signature Date�Q �l � ' Date: Firm By: Cit� of Yelm �3E � ���-84U2 REC#: OQ163409 6/13/20i4 3:17 PM OPER: CO TERM: 001 REF#; 1550 TRAN: 33.0000 BUILDING PERMITS 2014019Q 137.36CR MCGEE, SAM 15314 104TH WAY 5t BLDG 137.36CR TENDEREQ: 137.00 CHECK 0.36 CASFi APPLIED: 137.36- CiiANGE; � 0.00 �..�� ' ol�l�1 �� CITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM Project Address:� � 3� �'f' �a'�� �/a g 5� Parcel#: � L 3 Z Q��` 3 s,SO 4� I Subdivision: Lot#: Plan#: Zoning: New Construction P� Re-Model/Re-Roof/Addition Home Occupation Sign ' Plumbing Mechanical Mobile/Manufactured Home Placement � Other Project Description/Scope of Work: �� X 1 Z P�^'��, �•r"� Project Value: �S 11 O Building Area(sq. ft) 1St Floor 2"d Floor Garage Deck Basement Carport Patio #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 OWNER NAME: ADDRESS EMAIL CITY STATE ZIP TELEPHONE ARCHITECT/ENGINEER LICENSE# ADDRESS EMAIL CITY STATE ZIP TELEPHONE GENERAL CONTRACTOR :� � --, - r'�� TELEPHONE 2.�3--�f 2E.� -2 3� �o ADDRESSJ���3vr f87� EMAIL���S��-,T.f¢c�r;'-,c �.�-��-���:��cu �`-� f CITY Y�(..�, STATE �✓.� ZI P 98�Q 7 FAX CONTRACTOR'S LICENSE#a3t�6 G�1 �14$ EXP DATE� 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 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. �' � � y ' � �� � Applicant's gnature Date Owner/Co ractor/Owner's Agent 1 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 � 105 Yelm Auenue West (360)458-3835 Yelm,WA 98597 (360)458-3144 FAX www.ci.yelm.wa.us \-} 4.4. V "y ,t_^ � w'1� _ ) � } \1 � -v :t.3 � � {� � 1 ;3 � �� Q � U ��C. O � � � � U ! .� �` � �— ,�9 ; � � � , � � � � � �`� � :�� P fv� �'� M � � � v � � �� .�. 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