20110166 Bldg Application 06242013 C1TY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: %d��^-,� �`�'� '� ,l��''rj'G�`'�`jParc:el#: ���..L '%��.�%D Cj /
Zoning;
(°_�_ Current use:l�� ��t�_Proposed use: ,' � .�/.�r/
�New Construd'an ❑ Re-Modei!Re-Roof/Tenarrt Improvement
� Plumbing C Mechanicai D Fire P�+event/Suppress�Afarm 0 OtherC , /��
Project Description/Scope of Work: �.� i�c•e 1'��<n Rf �h ��r�;r� � r t � ...��-
Project Value: "" � O��! t��1C�.��
Building Area(sq•ft) Partang Garage 1�Floor���2nd Floor 3`�Ftoor
Building Height /•-S`�
Are there any environmentally sensitive areas located on the parcel? � If yes,a
completed environmental checklist must accompany permit application.
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CONTRACTOR'S LICENSE# � '7'"�.`�' �' EXP DATE' s CITY LICENSE#
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CONTRA T R'S LICENSE#Ho7Al/���/r r/�!'1 EXP DATE d/ CITY LICENSE#
Copy ot City Mitigation documeMation(TFC).
I hereby ce�tify tl�at the above Mtormation is correct and that the constructlon on,and the ocau�ncy and the use of the
above described property will be in accordance wkh the laws,rules and regulations ot the State ot Washington and�e
City m. �
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Ap lica s Sig ture ��
Owner!Corrtra r i Owner's Agent/Contractor's Age�1 Tenan# (Please circle one.)
All permits are non-transfierable and witl expire if work authorized by such permit is not begun
within 1$0 days of issuance,or if work is suspended or abandoned for a peri f i84ri�------�
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� JUN 2`4 2013
105 Yelm Aaenue West ��«_ 6
PO Box 479 (360)45&3144 FA%
Yeim,WA 98597 mwm.ci.yeim.ma.us
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