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20150132 Permit Pkg 03022015City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Applicant: Name: MARGARET CLAPP Address: PO BOX 5210 YELM WA 98597 Property Information: Site Address: 207 STFVFNS AVF NF Assessor Parcel No.: 64421300300 Contractor Information: Name: MARGARET CLAPP Address: C/O GAIL RIVAS PO BOX 5210 YELM WA 98597 Contractor License No.: Project Information: Project: DEMOLITION Description of Work: DEMO HOUSE Sq. Ft. per floor: First Second Third Garage Basement Fees: Item DEMOLITION Permit No.: 20150132 Issue Date: 3102/2015 (Work must be completed within 180 days) Phone: 360- 458 -7563 Owner: MARGARET CLAPP Subdivision: Lot: Phone: Expires: 0 /00 /0000 Heat Type (Electric, Gas, Other): Contractor MARGARET CLAPP TOTAL FEES: Applicant's Affidavit: 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 strictions of record. If applying as a contractor, I further certify that I am currently registered in th tate of Washington. Signature Date Firm Fees $ 50.00 $ 50.00 OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: City of Yelm (36 ) 458 -3244 REC #: 00188079 3/02/2015 10:56 AM OPER: CO TERM: 001 REF #: PAID BY: ACCT #: XXXXXXXXXXXXXXXXXXX AUTH #: 08942G TRAN #: 000000000719 IRAN: 33.0000 BUILDING PERMITS 20150132 50.000R CLAPP, MARGARET 207 STEVENS AVE NE DEMO 50.00CR TENDERED: 50.00 CREDIT CARD APPLIED: 50.00 - CHANGE: 0.00 A 2015 0 CITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM Project Address: 2-0-q Sk Nj_ Parcel #: Subdivision: Lot #: Plan #: Zoning: _ New Construction Re -Model / Re -Roof /Addition Home Occupation Sign Plumbing Mechanical Mobile / Manufactured Home Placement Other Project Description /Scope of Work: :. Project Val Building Area (sq. ft) 1" Floor, Basement 2 "0 Floor Garage Carport Patio Deck # 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. BUILDING OWNER NAME: t \e.. %- - C (, ADDRESS 7_U-4 S «-) - EMAIL CITY �[ I r l- STATE td A ZIP Ct , G `i-4 TELEPHONE ARCHITECT /ENGINEER LICENSE # ADDRESS EMAIL CITY STATE ZIP TELEPHONE GENERAL CONTRACTOR Wt,.. j A `)o _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 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. tt // J -IZ 1� Appwiirl :,s Signatu Date Owner I Contra r I 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 105 Yelm Avenue West (360) 458 -3835 Yelm, WA 98597 (360) 458 -3144 FAX www.ci.yelrn.wa.us Olympic Region Clean Air Agency 2940 -B Limited Lane NW Olympia, WA 98502 (360) 539 -7610 - FAX (360) 491 -6308 Pon Angeles Office (360) 417 -1466 Raymond Office (360) 942 -2137 www.ORCAA.org [7( Other Structure (10 working day wait period) T__T 7 f%%Vrk Y'C Contractor Asbestos Permit Q Owner Occupied Residential Dwelling (prior notice) FROrEni a vw— ++ Name: Margaret Clapp Phone: ( ) Email: Fax: ( ) Mobile: ( ) Mailing Address: Box 5210 C' Cl1y" Yelm State: WA Z P :98597 Site Contact Person: Dominic Rivas Phone: (253)279-0120 Email: Fax: ( ) Mobile: ( ) Site Address: 207 Stevens St NE City` Yelm State: WA Zip:98597 ASBESTOS CONTRACTOR Contractor /Business Name: Advance Environmental Inc Phone: (360)357-5666 Email:.dvaneeerwim,.enWCco noast.raot j Fax: Ci60 )357 -5665 Mobile: ( ) Mailing Address: 3620 49th Avenue SW City: Olympia Stat" WA Z'p'98512 -D-D RO ECT INFORMATION Start Date: + Completion Date: 3 - [C] 1,000 -9,999 linear or 5,000 - 49,999 s feet Work Shift Days: Work Shift Hours: 12/10/2014 Emergency $50 M_ T W_ Th_ F_ Sa_ Su_ $500 # Structures to be Abated: Total Quantity to be Square Feet:205 Linear Feet40 1 Removed Disposal Site: i Receive date: _ /_ /Z; . (t- Will all identified asbestos be removed from Will this structure be demolished after asbestos structure? l;€ Yes No removal? Yes [3 No Material(s) being removed: —Boiler /Furnace _X-Duct Insulation _Pipe Insulation _Fireproofing Paints _Plaster _Cement Board _ Ccment Pipe X Flooring _Roofing _Textured Coating _Other ASUECTOS PRQjTz "T (`A'T'F.G0RV NON- KhVU.NJJAtS_.r. rrr. 1- F] 10 -259 linear or 11 -159 square feet C 2 - 260 -999 linear or 160 -4,999 square feet $150 1 $325 3 - [C] 1,000 -9,999 linear or 5,000 - 49,999 s feet $650 4 - n 10,000+ linear or 50,000 square feet $1,300 Emergency $50 [L7 Annual - limit of 260 linear feet or 160 square feet $500 I do hereby certify that the information contained on this form and sxpplemental data described berein is, to the best of ray knowledge, accurate and complete. / �J�Nw /� �L"'"'— 11 /25/2014 nN Tina M. Sturdevant � Applicant Name Signature Date Date Application Received Payment Info,��a, Approved Asbestos a t: j �ASBOO� � C J�EL I [ ] Cash ` [ ]Disapproved Permit # ^ ` Chec �redit Card cc'' Review date: � /��1� Demolition Permit Permit # DEM00 i Receive date: _ /_ /Z; . (t- Reviewed by -. -Survey: MYes [ ] No AgeW!V,re Only Agency Use Only Agency Use Only en Use On 02/13 OVER