20140282 Permit Pkg 11202014 .
�o� TH�p,� City of Yelm Permit No.: 20140282
�
a � Community Development Department Issue Date: 11/20/2014
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
YEL
"'.`"'"`T°" Fax: (360)458-3144
Applicant:
Name: ROBERT SOWERS Phone: 360-701-0325
Address: PO BOX 1370
MCKENNA WA 98558
Property Information:
' site Address: 10015 TAHOMA CT SE Owner: ROBERT SOWERS
Assessor Parcel No.: 78640012100 Subdivision: TAHOMA MEADOW, Lot: 121
DIVISION II
Contractor Information:
Name: ROBERT SOWERS Phone:
Address:
PO BOX 1370
MCKENNA WA 98558
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: RESIDENTIAL REMODEL
Description of Work: INSTALL BATHROOM, SINK AND TOILET
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
BUILDING ROBERT SOWERS $ 23.50
PLUMBING ROBERT SOWERS $ 27.00
TOTAL FEES: $ 50.50
ApplicanYs Affidavit:
I certify that I have read and examined the information contained within the application and know the same OFFICIAL USE ONLY
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 Washi ton.
Signature Date �(��� �y Date:
Firm BY�
Cit� af se8m02
(36 )
REC#: 00178760 11/20J�01� 4:45 PM
OPER: CO TERM: OQ1
REF#:
TRAN; 33.0000 �����I50 50CRITS
2U1402�2
SOWERS, ROBERT
10U15 TAHOMA ��23�50CR
BLDG 27.00CR
PL
TENDERED: 50.50 OTHER
A�'PLIEQ: 50.50-
CHANGE: 0.00
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CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
� Project Address: I���5��C��4. C/'�,��Parcel#:
Subdivision:/C�lldLlC4.-!��?"d Lot#:� Plan#: c'X�O� � Zoning:
2v�
[? New Construction C; Re-Model/Re-Roof/Addition i�' Home Occupation Sign
�yPlumbing "-i Mechanical �� Mobile/Manufactured Home Placement ��� Other
Project Description/Scope of Work:�6'!(�011 �7c%,�,�,�,d✓i ��Siv�(C .� ??,�'�
�''-
Project Value: ��(.�
Building Area(sq.ft) 15i Floor x' 2"d Floor Garage Deck
Basement Carport Patio
#Bedrooms_ #Bathrooms_ Heating G S OTHER or ELECTRIC(Circle One)
Are there any environmentally sensitive areas located on the parcel? V�
!f yes,a completed environmental checklist must accompany permit application.
BUILDING O��NE NAME: 1— 6 ue{�- 6�C✓J
ADDRESS 1"()�O,sG, (3 �J EMAIL �o.Sfei Q�i Lru�:c�.n,
CITY�.12i�,u, STATE ZIP ?`� TELEPHONE 3�v '7 Ul t�3 Z��
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 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 described property will be in accordance with the laws,rules and regulations of the State of Washington and the
City of Yelm.
; ���/���
Applic Ys Signa ure Date
Owner/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
_ . __._.�._.�_�
;.���
NOV 2 � 20�4
105 Yelm Auenue West (360)458-3835
Yelm,WA 98597 (360)458-3144 FAX
. _ ___ ..--------
www.cc.yelm.wa.us _ ___._.��__
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