20150138 Permit Pkg 03112015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: RICK ROCHESTER
Address: 4810 45TH ST SE
LACEY WA 98503
Property Information:
Site Address: 108 SECOND ST NE
Assessor Parcel No.:
Contractor Information:
Name: RICK ROCHESTER
Address:
4810 45TH ST SE
LACEY WA 98503
Contractor License No.:
Project Information:
Project: ROOF
Description of Work: REROOF
Sq. Ft. per floor:
First
Second
Third
Garage
Basement
Fees:
Item
ROOF
Subdivision:
Permit No.: 20150138
Issue Date: 3/11/2015
(Work must be completed within 180 days)
Phone:
Owner: RICH ROCHESTER
Phone:
Expires: 0 /00 /0000
Heat Type (Electric, Gas, Other):
Contractor
RICK ROCHESTER
TOTAL FEES:
Applicant's Affidavit:
I certify that I have read and examined the information contained within the application and know the same
to be true nd correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm reg lations i in hose governing zoning and land subdivision, and in addition, all covenants,
easeme s a restriction of record If app/ as a ntractor, I further certify that I am currently
registere in t to o ashi
t /
Signatur C Date
Firm
Lot:
Fees
$ 25.00
$ 25.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Yolm
(36 ) 458 -3244
REC #: 00189198 3/11/2015 12:11 PM
OPER: CO TERM: 001
REF #: 9674
PAID BY:
TRAN: 33.0000 BUILDING PERMITS
20150138 25.000R
ROCHESTER, RICK
108 SECOND ST NE
UNAPPLIED 25.00CR
TRAN: 33.0000 BUILDING PERMITS
20150137 25.00CR
ROCHESTER, RICK
1314 SPRAGUE ST NW
ROOF 25.00CR
TENDERED: 50.00 CHECK
APPLIED: 50.00-
CHANGE: O.00
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: ��c� , Parcel #:
Subdivision:
Lot #: Plan #: Zoning:
2D( s yr 3g
New Construction ARe -Model / Re -Roof / Addition Home Occupation Sign
Plumbing - Mechanical Mobile / Manufactured Home Placement I I Other
Project Description /Scope of Work:
Project Valu
Building Area (sq. ft) Vt Floor 2nd 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?
/f yes, a completed environmental checklist must accompany permit application.
BUILDING OWNER NAME: ardt-
ADDRESS 400 � .R U= r EMAIL r NGT
CITY &,EC -_ STATE ,&,&, ZIP- TELEPH NE
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR b9f TELEPHONES
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.
Applicant's'Signat&e 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
105 Yelm Avenue West (360) 458 -383
Yelm, WA 98597 (360) 458 -314" 0 9 2015
www.ci.yelm.wa.us