20140300 Permit Pkg 12222014 'f''o� TH�a,��' City of Yelm Permit►vo.: 20140300
k' 9
� � Community Development Department Issue Date: 12/22/2014
d � (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
YEL
""'"°"fi" Fax: (360)458-3144
Applica�t:
Name: BILLY SMITH Phone: 360-790-8273
Address: 16548 RAINIER VIEW DR SE
YELM WA 98597
Property Information:
site Address: 16548 RAINIER VIEW DR SE Owner: BILLY SMITH
Assessor Parcel No.: 63540002900 Subdivision: MOUNTAIN SUNRISE, DIV. I Lot: 29
Contractor Information:
Name: HOME DEPOT AT HOME SERVICES Phone:
Address:
140 COUNTY LINE ROAD#140
PACIFIC WA 98047
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: ROOF
Description of Work: REMOVE AND REPLACE 22.3 SQ COMP ROOFING. NO PLYWOOD REPLACEMENT
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
ROOF HOME DEPOT AT HOME SERVICES $ 25.00
TOTAL FEES: $ 25.00
ApplicanYs Affidavit: OFFICIAL USE ONLY
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 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 Washington.
Date:
Signature Date �
By:
F��, o,�.a� n�-�-
Cit� of ��lm
(36 } 45�-�402
REC#; 00181403 1Z/22/2014 12:41 PM
OPER: CO TERM: 001
REF#: 9750
TRAN: 33.0000 BUILDING PERMITS
2014030� 25.00CR
SMITH, BILLY
16548 RAINIER VIEW DR SE
ROOF 25.00CR
TENDERED: 25.00 CHECK
APPLTED: 25.00-
CHANGE: 0.00
a�� �� ��
CITY OF YELM
RESIDENTIAL BUIL.DING PERMIT APPLICATION FORM
Project Address: 16548 Rainier View Dr Parcel#: 63540002900
Subdivision: _ Lot#: Zoning;
New Construction �/ Re-Model/Re-Roof/Addition Home Occupation Sign
Plumbing Mechanical Mobile/Manufactured Home Placement Other
Project DescriptionlScope of Work: Remove/replace 22.3 sq.comp. roofing; no plywood replacement
Project Value: �9�868.69
Building Area (sq. ft) 1St Floor 2"d 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? If yes, a
completed environmental checklist must accompany permit application.
BUILDkNG OWNER NAME: ����y smitn
ADDRESS �seaa Ra��ie�v�eW o� EMAIL
CITY YE�M STATE wA ZIP 9859� TELEPHONE 360-481-5561
ARCHITECTIENGINEER LICENSE#
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR Home Depot At Home Svcs. TELEPHONE $00-381-5699
ADDRESS �4o co��ty�me Rd#�o�, EMAIL
C�N PACIFIC STATE wa ZIp saoa� FAX
CONTRACTOR'S LICENSE# HOMED••972RG! EXP DATEz��s CITY LICENSE# 001419.0
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE_CITY LICENSE#
MECHANICAL CON7RACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE_CITY LICENSE#
Copy of mitigation agreement with Yelm 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.
•
lYApplicant's Sig ature Date
Owner/Contractor/Owner's Agent/C�►�+�a�+�r'� e�p�(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
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' P,FC 2 � ?_G14 f
105 Yelm Auenue West � _ (360)458-3835 ;
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PO Box 479 i.��_��,_�,.,�.K_(,360J 458-3144 FAX �
Yelm, WA 985.97 fwww.c�"a.y�l�rt:zi��