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20140223 Permit Pkg 08212014 �pF THEA�� City of Yelm Permit ►vo.: 20140223 � 7 � � Community Development Department Issue Date: 8/21/2014 (Work must be completed within 180 days) Building Division Phone: (360)458-8407 YEL '""°» 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: 14808 91ST AVE SE Owner: NORTHWEST FAMILY HOMES Assessor Parcel No.: 33860000800 Subdivision: BELLA HOUSA Lot: 8 Contractor Information: Name: NORTHWEST FAMILY HOMES Phone: Address: PO BOX 39 EAST OLYMPIA WA 98540 Contractor License No.: NORTHFH954BE Expires: 1/05/2013 Project Information: Project: NEW RESIDENTIAL BUILDING Description of Work: LOT 8, 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 SUNSETAIR INC $ 78.25 PLUMBING ACME PLUMBING $ 132.00 TOTAL FEES: $17,722.16 ApplicanYs Affidavit: OFFICIAL USE ONLY I certify that I have read and examined the information contained within the application and know the same to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints: Yelm regulations including those governing zoning and land subdivision,and in addition,all covenants, easements and restrictions of record. If applying as a contractor,I further certify that I am currently Final Inspection: registered in the State of Washingt n. Signature Date v � ���� ! Date: By: Firm 2�" lM� ' ?�l. �EPRI�T YELM CQMMUNITY SCHOOLS PO BOX 476 YELM WA 98597 Receipt #: 262033 Clerk: Croy Cit� of V�lm Manual #: Terminal: 1 (�6 ) 458-�402 8/21J201h 10:17 AM RE.C#: 0017G021 fl/�1%2014 10:L0 AM UC'ER. CO TE.RM. C101 NNW FAMILY HOMES REF#: 82� NNW FAMIL'� HOMES NORTHWEST, FAMII.Y HQMES iRAN: 33.00C10 BUILClING f'ERMITS 7426 MANZANITA DR NW 2�14p222 17,i22.1nCR OLYMPIA, WA �8502 NORTHWE,�r FAMiLY HOMES 14715 91ST AVE S� Qty___It�m_ ___ _- _ _Pr�ice �LD-R�51 17,511 .91C,I� 1 CPF MITIGATTON 3015.0� MECH �$�Z��� MITTGATTON p� 132.00GR 07-016/LOT �/14$08 91ST AVE SE;Y�LM TRAN: 3�.U000 BUlLDING PERMITS 2014U�23 17,722.1bCR 1 Cf'F MITIGATIQN 3015.00 NORTHW�ST FAMILY HOMES MITIGATIDN 14808 91ST AVE SE BLD-RES1 17,511 ,91CR 07-01"n/LOT 50/147i5 91ST AVE SE/YELM MECH 78o25C,R p� 134,OUCR Subtotal 6Q30.OQ Tax 0.00 TENQEf�tn: 35,444.32 GNECK Total 6030000 APPI.IED. 35�����32- Debit/Credit 6030.00 CHANGF: r� ��n� Ghange Due 0.00 THANK YOU I�0��,� � C(7"Y OF YELM RESIDEMf1AL BUILDING PERMlT APPLICA7iO1V FORM Project Address:_�yf�0�3 f l �� /q-trt ,re Parcei#:_ 3 3 86 oa o o �,o 0 Subdivision:��Z��� ►T11�('G, Lot#: g Plan#: Z.r � Zoning: .�New Canstruction r: Re-Modet/Re-Roof/Addition t; Home Occupation Sign r i Piurnbing i Mechanicai �:i Mobile/Manufaciured Home Placement �i Other Project Description/Scope of Wor :��+b•i/'�I t��� t:�t �' �1;� s��2 Project Value: Building Area(sq. ft) 1St Floor �2S� 2°d Fioor � 3 Garage�� Deck Basement Carport Patio-Wrcl. Il��/ #Bedrooms� #Bathrooms?�(y Heating: AS THER vr ELECTRIC(Circle One) Are there any environmentally sensitive areas located on the parcel? lf yes,a completed environmenfal checklist must accompany perrnit applieation. BUILDING O NER NAME:_�!;;)d'/--���„�c'3'�- f--� "vi� t �.� r�Y+ t� ,� ADDRESS �i:� i�L?i� ���J EMAIL ��r, �° � � r� �-c;,;,�v�,c_L;s•�, �1 r� c c' ' CiTY t'�- sl� w `�STATE Lv�fi Z1P���"�t�3 TELEPHONE_�t�G��7 71-�Z y'� ARCHiTECTfENGINEER__L�'��'1���!`vt,-. Ey�'��c r��Y1�1�ENSE# ADDRESS��1� Gi;,�Gc ���;�% L)�. S�-a EMAIL CITY�t,�;•j�i,J�_�k,- STATE ':-LJ•�} ZfP �j��i L TELEPHONE _ _ GENERAL CON7RACTOR/�%;'i^tl�b�/�!i- F'u�v�i`�� ��L�n'iTELEPHONE '3 u�''�1/- j�• r1`LI ADDRESS__��.i,'. I���x 3��� EMAIL _✓'}'6��c CcY�•;� �� �?Lv����;I'f,ltr� C�� �'�! 4�1 t�ra iG� S7ATE �_ 1.�1:�} ZiP �;vS�l�' FAX ° CONTRACTOR'S ICENSE#niyt?n�FN�i5yl3c EXPDATE CITYLICENSE# t-S-ij PLUMBING CONTRACTOR�ei�� •d+s���i3iK% V' TELEPHONE�CC -y<f(- 73.i��f ADDRESS �"7.�� �'i�a�;`tC�r EMAIL CiTY_��i��uH y�;'�. STATE t,�,t} ZlP_y�s'13 FAX CONTRACTOR'S LICENSE#At�•yEPl�=y�j'�r�� EXP DA"fE CITY LICENSE# ._3__� — MECHANICAL CONTRACTORJc������t C;�1r TELEPHONE �>;Z� �-�/y.37, ADDRESS_��i�� Li3 c ic� (�j�,�� EMAIL CITY �„�;� zc,� STATE W� Z�P `i f���� FAX ' CONTRACTOR'S LlCENSE#,li�N.fC-��'La,tc.,v� EXP DATE CITY LICENSE# Copy of mi6gation agreement with Yefm Community 5chools,if appficable. f hereby certify that the above information is correct and that the construction o�,and the occupancy and the use of the above described property wilf be in�ccordance with the laws,rules and regulations of the State of Washington and the City of Ye(m. � � '_ Z( —� Appiicant s Signature Daie Owner I Contractor/Owner's Agent/Contractor's Agent{Please circle one.) A(1 permits are non-transferabfe and wiil expire if work authorized by such permit is not begun vy'�thin 180 days of issuance,or if work is suspended or abandoned for a period vf 180 days f� � � 705 fes'n:ttuererse West -- {360)458 8 Yeirn,WA 98597 1�'Q .�j C��'+�,j'i��° www.ci.yelm.wa.us {36Q)458- '4°h� ; . JUL 22 2014 j �:o'. 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