20150104 Permit Pkg 01282015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: THE CATTLEMAN
Address: 16222 159TH LANE SE
YELM WA 98597
Property Information:
Site Address: 1 J;nA YFI M AVF W
Assessor Parcel No.: 21713340405 Subdivision:
Contractor Information:
Name: OUTHOUSE PLUMBING
Address:
9227 KILLION RD SE
YELM WA 98597
Contractor License No.: OUTHOP*990BP
Expires:
Permit No.: 20150104
Issue Date: 1/28/2015
(Work must be completed within 180 days)
Phone: 253- 720 -1615
Owner: CLARK SUMNER
Phone: 458 -6607
Project Information:
Project: PLUMBING
Description of Work: LINE RUNNING TO DOUBLE SINK
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
PLUMBING
Contractor
OUTHOUSE PLUMBING
TOTAL FEES:
Applicant's Affidavit:
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
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
registered in the State off Washin ton.
Signature � �L' lAliA Date
Firm
Lot:
Fees
$ 27.00
$ 27.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Mm
(36 ) 458 -8402
REC #: 00184763 1/28/2015 3 :55 PM
OPER: CO TERM: 001
REF #:
IRAN: 30.0000 BUSINESS LICENSE
THE CATTLEMAN
BUSINESS LICENSES & 35.000R
TRAN: 33.0000 BUILDING PERMITS
20150104 27.00CR
THE CATTLEMAN
1506 YELM AVE W
PL 27,OOCR
TENDERED: 62.00 OTHER
APPLIED: 62,00-
CHANGE: 0,00
2060 lob
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: (SW w Yelp AvC Parcel #:
Zoning; MP1(\CCt Current Use: Proposed Use:
New Construction ❑ Re -Model / Re -Roof / Tenant Improvement
Plumbing ", Mechanical ❑ Fire Prevent/Suppress /Alarm Other
Project Description /Scope of Work: ltkm b, R
Project Value:
Building Area (sq. ft) Parking Garage 1s` Floor 2nd Floor 3`d Floor
Building Height
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER/TENANT NAME: ,,,cK
ADDRESS i � iUV\e_, Se EMAIL s(Am f-Za > I 66:--7
CITY ,I�L^g STATE i,VA ZIP 01,q �7 TELEPHONE ot$3 7�y-1Crf
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
PLUMBING CONTRACTOR Cj cu 21,)owr, TELEPHONE S(ac) _' Z -F- 0-3, -7j
ADDRESS� . EMAIL '7 I
CITY STATE_,_L�ZI P FAX
CONT CTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
Copy of City Mitigation documentation JFC).
I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the
above described property will be in accordance with the laws, rules and regulations of the State of Washington and the
City of Yelm.
Applicant's Signature Date
Owner / Contractor / Owner's Agent / Contractor's Agent / Tenant (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
(360) 458 -3835
105 Yelm Ave W (360) 458 -3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us