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