20140243 Permit 09082014 '�''o� TH�o,�`�"' City of Yelm Permit No.: 20140243
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� �� Community Development Department Issue Date: 9/08/2014
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
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""•6"'""p" Fax: (360)458-3144
Applicant:
Name: OYSTER BAY GROUP 3, INC. Phone: 360-352-1970
Address: 1800 COOPER POINT RD SW, NO 8
OLYMPIA WA 98502
Property Information:
Site Address: 1405 YELM AVE E owner: So.1AK
Assessor Parcel No.: 22730140400 Subdivision: Lot:
Contractor Information:
Name: OYSTER BAY GROUP 3, INC. Phone:
Address:
1800 COOPER POINT RD SW, NO 8
OLYMPIA WA 98502
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: LAND APPEAL
Description of Work: DECISION BEING APPEALED
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
APPEAL OYSTER BAY GROUP 3, INC. $ 50.00
TOTAL FEES: $ 50.00
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 atl 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 Washington.
Signature Date Date:
Firm By�