20140196 Permit Pkg 07152014 �o� �HFp,� City of Yelm Permit ►vo.: 20140196
�
� �� Community Development Department Issue Date: 7/15/2014
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
EL
"'•""'""°" Fax: (360)458-3144
Applicant:
Name: SANDY CAVIN Phone: 360-661-5880
Address: 211 MOSMAN AVE SE
YELM WA 98597
Property Information:
site,4ddress: 211 MOSMAN AVE SE Owner: SANDYCAVIN
Assessor Parcel No.: Subdivision: Lot:
Contractor Information:
Name: WEATHERGUARD ROOFING INC. Phone:
Address:
3929 MARTIN WAY E.#B
OLYMPIA WA 98506
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: ROOF
Description of Work: TEAR OFF ROOF AND INSTALL 30 YEAR ROOF
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
ROOF WEATHERGUARD ROOFING INC. $ 25.00
TOTAL FEES: $ 25.00
Applica Ys OFFICIAL USE ONLY
I certify I have read and examined the information contained within the application and know the same
to be tr e and correct. also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints:
Yelm r ulat� ns incl ing those governing zoning and land subdivision,and in addition,all covenants,
easem nts d rest ctions of re rd. If app �ng as a contractor, I further certify that I am currently Final Inspection:
registe d in he St of W n ton.
Signatu e Date S Date:
Firm By�
Cit� af Y�lm
(36 ) 456-8402
REC#: 00166210 7/15/2014 9:51 AM
OPER: CO TERM: 001
REF#: 31407
TRAN: 33.0000 BUTLDING PERMITS
20140196 25,OOCR
CAVIN, SANQY
211 MOSMAN AVE SE
ROOF 25,OOCR
TENDERED: 25,00 CHECK
APPLIED; 25.00-
CHANGE: 0.00
06l26I2014 16:06 3609436473 � l ,��� w.� PAGE 01101
(J� (1
G1TY OF YELM
RESIDENT'IAL BUI�D{NG P�RMIT APPLICATION FORM
Project Address: � Parcel#:_.
Subdivislon: Lot#: Plan#: Zoning:
0 New Construction Re-M el/Re-Raof ddition 0 Nome OcCUpation Sign
❑ Plumt�ing 0 Mecha ical i e/Manufact red Horr�re Placement p Other
Project Descrlptlon/Scope of Work:
Project Value: �3� d ��i�
Building Area (sq. ft) 1�t Floor 2°�Floor . 3f°Floor Garage-2 car 3 car •
Covered Patio Covered Porch Patio Deck. _
#Bedroams_ #Bathrooms,_ Heafing:GAS/OTHER vr�LECTRIC(Circle One)
Are there any enviranmentally sensitive areas located an the parcel?
If yes, a completed environmentaf checklist must accompa�y permit application.
SUFi��I�l�il �,- �t,'. �<,� .�:
ADDR EMAIL
CITY TA"C� ZIP TEL�PFlONE
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ADDRESS �MAIL
CITY STATE�,�ZIP TELEPi-10(�fE
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ADD SS �MA
CITY� STAT� z]P FAX �-
CONTRAC R'S LICENSE# XP f�ATE ITY LICENSE#
F�',Lil�l�f��.l�t�C�'!�`�Jl,4T��'�,,', TELEPHONE.
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LIC�NS�# � EXP DAT�_CITY LICENSE#
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ADDRESS �MAIL
CITY STATE�IP� FAX
CONTRACTOR'S LIGENSE# EXP DqTE_CITY LIC�iVSE#
Copy of mitigation agreement with Yelm Communi#y Schools,if applicable � (�• ��
I hereby cartify tnat tf�e above infv„nation is correct and that the const�uctlon on,and the oCupa c a uss oE tna
above escribed property wtll bm In accortlanco with tne laws,ruEes and regulatiores of the State ot was6ingtvn and the
CEty o ol �
/
p licant's Stgnature Date
Owner/Cvntractor/Owner's gent/Contractor's Agent(Please circle one.} �
AI!permtts are non-transferabEe and will expire if work authorized by such permit is nat begun
wlthirt 180 days of issuance,or if work is suspended or abancioned#or a period of 180 days
�� 6l� � t�.� a�n/�
IOo�e%m Auenue WeeE (360)465-383b
Xelm,WA 98697
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JUN 2 6 2014
� BY: