20140255 Permit Pkg 10012014 �o� TH�p,� City of Yelm Permit No.: 20140255
�
� � Community Development Department Issue Date: 10/01/2014
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
ELM
""""'""°" Fax: (360)458-3144
Applicant:
Name: MARIACHI ALEGRE Phone:
Address: 717 YELM AVE
YELM WA 98597
Property Information:
Site Address: 717 YELM AVE 1 Owner: MARICAHI ALEGRE
Assessor Parcel No.: 22730120101 Subdivision: N/A Lot: N/A
Contractor Information:
Name: J.R. ROOFING, INC Phone:
Address: JOHN W. RITCHIE
4426 16TH AVE SE
LACEY WA 98503
Contractor License No.: Expires: 0/00l0000
Project Information:
Project: ROOF
Description of Work:
Sq. Ft. per floor: First Heat Type(Electric,Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
ROOF J.R.ROOFING, INC $ 25.00
TOTAL FEES: $ 25.00
ApplicanYs Affidavit: OFFICIAL USE ON�Y
I ceRify 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 zo i g and land subdivision, and in addition,all covenants,
easements a strictions of record. I yi as a contractor,I further certify that I am currently Final Inspection:
registered th t e of W shington.
Signature ���"'vl Date a � �v�1' Date:
� BY:
Firtn . ,� l�} A/'� •
Cit� of Y�lm
(36 ) 458-8402
REC#: 00173233 10/01/2014 9:06 AM
OPER: CO TERM: 001
REF#: 11858
TRAN: 33.0000 6UILDI�S �OCRITS
20140255
MARIACHI ALEGRE
717 YELM AVE ��5 pOCR
ROOF
TRAN: 30.0000 BU5INESS LICE�ISE
10361 JR ROOFING INC 2�125 OOCR
BUSINESS LICENSES &
TENDERED. 50.00 CHECK
APPLIED: 50.00-
CHANGE; 0,00
,�=v
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: ! � � Ll3+51 �GI•M1�V� Parcel#:
Subdivision: Lot#: Plan#: Zoning:
i� New Construction ��' Re-Model/Re-Roof/Addition [� Home Occupation Sign
l 7 Plumbing I Mechanical �� Mobile/Manufactured Home Placement �� Other
Project Description/Scope of Work:�,_n�r�n��_ a� ��Its ��NS�HN� �e�/
�
Project Value: � �•
Building Area(sq. ft) 1S` Floor 2nd 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?
/f yes, a completed environmental checklist must accompany permit application.
BUILDING WNER M :
ADDRESS � EMAIL
CITY STATE P TELEPHONE
ARCHITECT/ENGINEER LICENSE#
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR Nt TELEPHONE -W�
ADDRESS � ,��- EMAIL
CITY STATE j�_ZIP FAX 3(co• �-I Sle• �{`I S
CON RACT R'S LICENSE# EXP DATE CITY 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 Yeim Community Schools, if applicable.
1 hereby certify that the above information is correct and that the construction on,and the occupancy and the use of the
above descr' ed property will be in accordance th the laws,rules and regulations of the State of Washington and the
City of Y
� I �D � /
Ap ' s Signature Date
O er/Contractor/Owner's Agent/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
J�, r�C-�.�,r ���-