20140217 Application 07212014 ,.».�.�...-
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CITY OF YELM JUL 2 1 2014
RESIDENTIAL BUILDING PERMIT APPLICATION FORM �
ProjectAddress:���� Q �Q 5� cJ`�, Parcel#: W������$�
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Subdivision: Lot#: �� Plan #:2�W Zoning:
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�'fVew Construction ❑ Re-Model/Re-Roof/Addition ❑ Home Occupation Sign
❑ Plumbing ❑ Mechanical ❑ Mobile/Manufactured Home Placement ❑ Other
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Project Description/Scope of Work:Yle1J� `�1N1C3�t'e �G1M1�1y Y�J\� �,V� �-1�j
Project Value: �°�°� � L��� .
Building Area (sq. ft) 1S� Floorl� 2"d Floor1S5�7 3�d Floor Garage-2 car.�3 car
Covered Patio�-�y Covered Porch ��� Patio Deck
# Bedrooms U #Bathrooms?-��2 Heating GAS/ THER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? N�
/f yes, a completed environmental checklist must accompany permit application.
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ADDRESS � � EMAIL
CITY STATE��ZIP TELEPHONE ZS3•�1�0' ��'_�O
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CITY �r STAT��C�-ZIP 2y FAX ZS'3•`�`QllO•l7tpUD
CONTRACTOR'S LICENSE#PRF,�,S'I�1O1�1N'1.�XP DATE CITY LICENSE#
F��,��tl���,;�''a� lUT#��"CQ 1 TELEPHONE 2.�3•2�a►-�'�b
ADDR SS � �. EMAIL
CITY STATE IP FAX 253•�°l�• 24Q�
CONTRACTOR'S LICENSE#�El."�'R'A�O`l�2EXP DATE CITY LICENSE#
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M�CHANI�AL,CC?NTRAC�"C� CY� V 1 1(p TELEPHONE ' � - �_
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GTY�CO� C1'N10�. STATE ZIP q$yy� FAX 253- �1- 3�10�—
CONTRACTOR'S LICENSE#1�L.�Ig?1�lW1Z�`�XP DATE CITY LICENSE#
Copy of mitigation agreement with Yeim Community Schools, if applicable.
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.
'1- 1L1• 14
Ap li nt's Signature Date
O ner Contractor/Owner's Agent/Contractor's Agent(Please circle one.)
AII 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
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105 Yelm Auenue West (360)458-3835
Yelm, WA 98597 (360)458-3144 FAX
www.ci.yelm.wa.us
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SCALE:1��=ZO� � � L DRYWELIJ �� �
ROOF
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NO 5' EAVE ,Ap p rovec�
ENCROACHMENT THIS LOT
/ CONNECT 4" PVC ROOF
Z `) l ��% DRAINS TO DRYWELL
STEP TANK EXCAVATION IN VIOLATIC2N -<-.---••�----�- - --
OF THE REQUIRED 5' MINIMUM SET BACK � ��
� FRONT PORCH FOUNDATION AND STEP
TO FOUNDATION SHALL BE BACKED ,. TION SHALL BE STAKED OUT
FILLED WITH CDF. � FOR SET BACK INSPECTION.
LOT 48 - CHERRY MEADOWS
PARCEL #: 416100 048 04 Date: owner; Freestone
_____ 07 / 10 / 14 �herru h�eac���v� L.I�G
Lot 51ze: Pro�ect Address: 6820 20th St, E 5uite A
5,200 Sq. Ft. 15419 KAYLA STREET SE 253 8 6� 300