PL-05-0459
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
PL-05-0459- YL
Issue Date 02/23/2006
(Work must be started within 180 days)
Receipt No
40946
Applicant:
Name: Hwy 507 Young Life
Address. 10618 SE Kent Kangley Rd.
Phone.
360-584-3983
City' Kent
State. WA Zip 98030
Property Information:
Site Address. 311 Yelm Ave. West
Assessor Parcel No. 75300900300
Subdivision.
Lot:
Contractor Information"
Name:
Contact:
Phone:
Address
City'
State:
Zip
Contractor License No
Expires.
Business License:
Project Information:
Project: Young Life
Description of Work: Add four fixtures for Coffee Shop
Sq. Ft. per floor' (1st) 0
(2nd) 0
(3rd) 0
Garage 0
Basement 0
Heat Type (Electric, Gas, Other):
Fees:
Item
Item Fee
Base Amt
Unit Fee
Unit Rate
No Units Unit Desc
Plumbing Permit
TOTAL FEES
48.00
$48.00
2000
28.00
7 0000
4 0000 Fixture
Applicant's Affadavit:
OFFICIAL USE ONLY
I 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 restrictions of record. If applying as a contractor, I futher certify that I am currently
::~:::~ Date~l~
# Sets of Prints.
F:7?b_
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
PAID
Permit Fees Schedule
FFR 2 ~ 71106
CITY OF YELM
Permit No PL-05-0459-YL
Applicant:
Name' Hwy 507 Young Life
Phone.
360-584-3983
Address. 10618 SE Kent Kangley Rd.
City' Kent
State WA Zip 98030
Project Information
Project: Young Life
Description of Work. Add four fixtures for Coffee Shop
Site Address: 311 Yelm Ave. West
Assessor Parcel No 75300900300
Fees.
Item
Acct Code
Item Fee Base Amt Unit Fee
Unit Rate No. Units Unit Desc
Plumbing Permit
032 001-322-10-00
48.00
2000
2800
7 0000
40000 Fixture
TOTAL FEES
$48.00
.0
o .
--
,<!/ ~ TH{'~'I>I CITY OF
i. x~:.. .0+ \1
, ~I '...
& ~ YELM
~' PO Box 479
. Yelm WA 98597
,.YE!-,f':L.., 360-.158-3403
RECEIPT No 40946
RECEIVED
****FORTY EIGHT DOLLARS & 00 CENTS
RECEIVED FROM
YOUNG LIFE
DATE REC NO
02/23/06 40946
AMOUNT
48.00 CHECK
REF NO
1005
311 YELM AVE W
YELM. WA 98597
BUDGETARY
MICHELLE
--~PLMB-PER SITE ADDRESS 311 YELM AVE W
~
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address. b\ \ ~I~VY\ ~..'\1\'.. Parcel#' 7S ~Oc9 ~Z:::>D~AN 3 0 2006
Zoning: Current use:9.:\r5Yt.U'lf- Proposed Use. (;0 ~op I ,
. '1w~Y\~.
o New Construction 0 Re-Modell Re-Roof 1 Tenant Improvement
)(Plumbing 0 Mechanical 0 Fire PrevenUSuppress/Alarm (.)~ Other
Project Description/Scope of Work: ~ '0J!Jm \)('l..vtJfY\JLY\Ji- ....r 5; I Vl. V /1 1-bJ.rh .e. Y\)SYY'\ , ~
Project Value: I t9J11 YY\O)') S' \ Vl/'L.
~ 1Af<a"'\ CLV\d \N )v\,
Building Area (sq. ft) Parking Garage~1st Floor 2nd Fluul 3fl1 FloOl_ Y\ $1\1\ \L..-
Building Height ~
Received
Are there any environmentally sensitive areas located on the parcel? 100
completed environmental checklist must accompany permit application.
'13UILDING -OvvNERitEN.A.N'r-NAME:
ADDRESS --- cae --.- G-\l.Q..Vt1-
CITY uA/t STATE 'VJ(J..
~RCHjfECT/EN9l.~ER
ADDRESS
CITY STATE
If yes, a
ZIP
LICENSE #
EMAIL
TELEPHONE
TELEPHONE g?;r;,I1- ,<'"6'/-- .3"78Y
EMAIL
FAX
EXP DATE CITY LICENSE #
@l::r~tt;RA,~ CQN_t8AC]OR
ADDRESS
CITY STATE
CONTRACTOR'S LICENSE #
ZIP
:e~JL~lt.i(t9bNfRAc'r6R
ADDRESS
CITY STATE
CONTRACTOR'S LICENSE #
MEbHA~ICAL CONTRACTQB
ADDRESS
CITY STATE
CONTRACTOR'S LICENSE #
ZIP
TELEPHONE
EMAIL
FAX
EXP DATE CITY LICENSE #
ZIP
TELEPHONE
EMAIL
FAX
EXP DATE CITY LICENSE #
Copy of City Mitigation documentation (TFC).
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, Riles and regulations of the State of Washington and the
City ofYelm.
~[~Jol Ci.r
(Please circle one.)
All pennits are non-transferable and will expire if work authorized by such pennit 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
PO Box 479
Yelm, WA 98597
(860) 458-9895
(960) 458-9144 FAX
www.ci.yelm.wa.us