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20150153 Permit Pkg 04062015
City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Applicant: Name: DON MILLER Address: P.O. BOX 5000 YELM WA 98597 Property Information: Site Address: Awi WFST Pn NF Assessor Parcel No.: 64303700201 Subdivision: Contractor Information: Name: BOB HOWARD JR CONSTRUCTION Address: BOB HOWARD P.O. BOX 1260 YELM WA 98597 Permit No.: 20150153 Issue Date: 4/06/2015 (Work must be completed within 180 days) Phone: 360- 458 -3211 Owner: DON MILLER Lot: Phone: 360- 701 -7757 Contractor License No.: BOBHOHJ965PO Expires: Project Information: Project: ROOF Description of Work: REMOVE AND REPLACE EXISTING ROOF Sq. Ft. per floor: First Heat Type (Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor ROOF BOB HOWARD JR CONSTRUCTION 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 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 applyi g,as a contractor, I further certify that I am currently registered in the S to 0'f ashin on. / / 1 Date Signature Firm Ar)4 14".1AX'a ae Fees $ 25.00 $ 25.00 OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: City of Y -32 (36 ) 458-3244 REC #: 00191062 4/06/2015 8:40 AM OPER: CO TERM: 001 REF #: 9980 PAID BY: TRAN: 33.0000 BUILDING PERMITS 20150153 MILLER, DON ROOF 403 WEST RD NE 25 OOCR TENDERED: 25.00 CHECK APPLIED: 25.00 - CHANGE: 0.00 L CITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM Project Address: VC-3 14)06T- R b S A Parcel #: 6` J 03,700- 0 1 Subdivision: Lot #: Plan #: Zoning: New Construction X Re -Model GEDAddition ! Home Occupation Sign Plumbing Mechanical Mobile / Manufactured Home Placement I, Other Project Description /Scope of Work: )Qe& 0Ue g;- /S�irc�q Project Valuer Building Area (sq. ft) 1St 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? Wo /f yes, a completed environmental checklist must accompany permit application. BUILDING OWNER NAME: A J I ADDRESS 0 '600 EMAIL CITY )6? 1 ✓ice, STATE L-e�,ZIP S TELEPHONE '1&_,9-36?11 ARCHITECT /ENGINEER LICENSE # ADDRESS EMAIL CITY STATE ZIP TELEPHONE GENERAL CONTRACTOR &O i5(^ "&9a_,1K ONstr —TELEPHONE .3ri,o-70/ - 77-5`7 ADDRESS /-," C7,,BO,r 1:?&0 EMAIL 6 ✓� //r ct CO,.- C.fSi:rdri CITY 7/& Ik" STATE _ZIP `Y,?SQ`> FAX CONTRACTOR'S LICENSE #BoBiYDf/S`J1oS'P ©EXP DATE[(�ITY 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. Applicants Signature Date Owner / tract 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 Yelm, WA 98597 www.ci.yelm.wa.us (360) 458 -3835 (360) 458 -3144 FAX