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20140222 Permit Pkg 08212014 �pF THEA�~"� City of Yelm Permit ►vo.: 20140222 � � Community Development Department Issue Date: 8/21/2014 d sn (Work must be completed within 180 days) Building Division Phone: (360)458-8407 YEL "»'"y`°" Fax: (360)458-3144 Applicant: Name: NORTHWEST FAMILY HOMES Phone: 360-791-5644 Address: PO BOX 39 EAST OLYMPIA WA 98540 Property Information: Site Address: 14715 91ST AVE SE Owner: NORTHWEST FAMILY HOMES Assessor Parcel No.: 33860005000 Subdivision: BELLA HOUSA Lot: 50 Contractor Information: Name: NORTHWEST FAMILY HOMES Phone: Address: PO BOX 39 EAST OLYMPIA WA 98540 Contractor License No.: NORTHFH9546E Expires: 1/05/2013 Project Information: Project: NEW RESIDENTIAL BUILDING Description of Work: LOT 50, PLAN 2590 Sq. Ft. per floor: First 1251 Heat Type(Electric, Gas, Other): GAS Second 1539 Third Garage 429 Basement Fees: Item Contractor Fees NEW RESIDENTIAL BUILDING NORTHWEST FAMILY HOMES $17,511.91 MECHANICAL SUNSET AIR INC $ �8.25 P�UMBING ACME PLUMBING $ 132.00 TOTAL FEES: $17,722.16 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 S e of ashington. t� ����j Date: Signature Date Gi / Firm i/�(/1��.(/`�Q/�` �l�G`/"���' BY. _ . REP�INT YELM COMMUNITY SCHOOLS PO BOX 476 YELM WA 98597 R�ceipt #: 26�033 Clerk: Croy 1���� �� ��I� Manual #. Terminal: 1 (36 } 458-fl402 8/21/201A 10:1� AM REC#: 00170021 fl/21%2014 10:20 AM UpER: CO TE.RM: C10� NN4V FAMILY NGMES REF#: 8Z2 NNW FAMILY HOMES NQRTMWEST, FAMILY HQMES J�qN; 3:�.OUC�O BtJII.UING F'ERMITS 74�6 MANZANITA DR NW 2014Q22'"L 17,�2?.1nCR OLYMPIA, WA 98502 NORTHWE�7i FAMILY HOMES 14715 91ST AVE $� Pr�ice BLD-RE51 1T,511 .�1C;� q_�_ Item _ — -- -- _ ME�H 78.25CR 1 CRF MITIGATION 3015.00 P� 13��OOCR MTTTGATION 07-016/LOT 8/14808 91ST AVE SE;YELM TRAN: 33.UOOG BUTLQING PE�tMITS 20140223 17,722.16CR 1 CPF MIT�GATION 3G15.00 NOR�HW�S�T FAMILY I�OMES MITIGATION 14808 91S"T AVE S� BLL�-RES1 17,511 .y1CR 07-U16/LOT 50/14715 91ST AVE SE/YELM pLCH 78'25CR 13L O�CR Subtotal 6Q30.OQ Tax 0.00 TENDEf�ED: 35�,4��.32- CHECK Total 6030�00 pPPLIEq: Debit/Credit 6030,00 CHANGE. V.r p,a0 Change Due O.OU THANK YOU ��� z��� CiTY OF YELM RESIDEI�fT1AL Bt11LDING PERMIT APPLtCA710N FORM Project Address: '�'I��� ����� f e Parcel#: 3 3�� OOD�� �a Subdivision:Q���� �k�ti Lot�: �� Plan#: ��� (� Zoning: .,y�i'�fVew Constructian i� Re-Model/Re-Roof/Addltion �; Home Occupation Sign � i Piumbing ._� Mechanicaf �:i Mobile!Manufactured Home Placement �� Other Project Description/Scope of Wo k: l-i}b•t l��! t�ca v'�" f�+� �1.� �F�� Projecf Value: ��1�� Buiiding Area(sq. ft} 15�Floor �Z�� 2"d Floor IS� I Garage�� Deck Basement Carport Pa#io� r' �y #Bedrooms ��" . #Bathrooms��Z Heating: AS THER or ELECTRIC{Circle One) Are there any environmentally sensitive areas located on the parce!? lf yes,a comp)eted environmental checkiist must accompany permit appiication_ BUILDtIVG O}�NER NAME: (1,�;;?r'�-G��,.�.''3��- �s•i�i , -� t �"� �' � ADDRESS f -4� �G�r� ��i EMAIL �'f�i�it�t.'Pr'� r� � �i✓t��c:i;s'�. tY1� CIN�ts r'��' tl! ;�v� �`°�STATE Lv+rfi ZIP C��,�3 TELEPHONE ��0�] 11-SZ�i� ARCHITECT/ENG(NEER %�'t+:�t`Yti��s'L'�,- E''`j 1�r r''�'i�.1'CENSE# ADDRESS (I'31'"�� L��� l��yft' U�- ��-' EMAIL CiTY�i�p�a w�f�° STATE i.�.�.� ZfP�j�.s i 1. TELEPHONE � GENERAL CONTRACTOR/�%r�°1��+�✓�'!1- l'r:ebr�i'J� I�ii�iTELEPHONE '3��'`��l f- S�' ��! ADDRESS ��.i?. 1��'� 3�f EMAIL i^3��G�C�ri`•rrf: �'GV��G'�:.f`f.f��`� C1TY�i:�t�' ��I�ix���niE� 57ATE �1.�.%:� ZIP��S`I��' FAX CONTRACTOR'S LICENSE#sAiy(!n�1=HtiSNl�c EXP DATE CITY LfCENSE# l-S-i� PLUMBING CONTRACTOR J���'�L !l�'bf�il3il� �'" TELEPHONE 3LC �'`f�f f- �:3��L! ADDRESS��,i� F i y�;`T G+�;• r EMAfL CtTY r,�I��u��;'�. STATE w,�� Z!P 9��s"i3 FAX CONTRACTOR'S LICENSE#R�i�aEPL��iti 3��' EXP DATE CITY LICENSE# 3 --�- � MECHANtCAL CONTRACTOR J%��.�sl'�C:�� TELEPHONE Lf�?� °-LI�i.3(� IADDRESS �.'-+�.� Lt}���i f�'1��Gt EMAIL CITY ),.r,;� �c� STATE L�-�� ZIP 1���?3 FAX ' CONTRACTOR'S LICENSE#lr,�N.i��r�t'LtrlGrw EXP DATE CITY LICENSE# 2 -?--( .. Copy of mitigativn agreement with Yelm Community Schools,ifi appliCable. (hereby certify that the above information is correct aad thai the construction o�,and the occupancy and the use of the above described property wilf be in accordance with the laws,rules and regulations af the State of Washington and the City of Yelm. 9 �.�-� � �� 7� �� '/�9 Applicant's Signature Date Owner/Contractor/Owner's Agent!Contractor's Agent{Please circle one.} All permits are non-transferabte and will expire if work authorized by such permit is not begun within 4 SO days of issuance,or if work is suspended or abandoned for a period af 180 days �� �__ � ���' � ��_���� , 705 Yeln�Auenue Wesi (360)458 835 Ye1�,WA 9859T �L 2 2 2014 wuw.ci.yelm.cua.+cs (3&0)458 3144 F I E '��. ��� ��e Co � � �-T SO �e ct� t-��r� `�EL j Z . �� +�p�L �t�- � S � --� g' ~M -� � ��.�-�,,. �v w1�!'�a c.� 5'' �,7 o c f s► pr�wL�"� Z S�n p,Gi 1� � �n-n o I N 7 r� � � �r �v c SE � ��'`�' P�►rccl � ���� OOO �DO�U � _ _ � CavrRp�! — — — � 4 B ru°"'` � e� „ r � y J � `v i�� fT R�T i7�� i� BE t�►tia�l� . � � �o 6' � � ` � F-iH� f�e+� F���v E�= (o -c� + - � -T � � Dl �� I v � � � -�;�t��-4 i n e. 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