20150131 Permit Pkg 03022015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458-3144
Permit No.: 20150131
Issue Date: 3/02/2015
(Work must be completed within 180 days)
Applicant:
Name: CITY OF YELM Phone 360- 458 -3244
Address: 105 YELM AVE W
YELM WA 98597
Property Information:
Site Address: 203 FIRST ST S Owner: CITY OF YELM
Assessor Parcel No. 64420100100 Subdivision:
Contractor Information:
Name: CITY OF YELM Phone: _
Address:
105 YELM AVE W
YELM WA 98597
Contractor License No.: Expires: 0 /00/0000
Project Information:
Project: DEMOLITION
Description of Work: REMOVE AND DECOMMISSION 2 UST TANKS
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other).
Second
Third
Garage
Basement
Fees:
Item Contractor
DEMOLITION CITY OF YELM
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 applying as a contractor, I further certify that I am currently
registered in the tate of Washington.
Signatures t }n� Date /
Firm � C� %vA / � J S� [ I cx --t -(f
Lot:
Fees
$ 0.00
$ 0.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
_A)i_S� 031
Projea Aridness 203 _5E I" 51►'tut Yclm WA Parcel #
Ctr4^t l Q., �,ki v,j #d �'
ZonirV. CuffeW Use G� a4� Proposed Use`
D New Cow Re -Mode4 / Re- 1 TenartPa ImprovemeM
Plumbing anicai Fire Pre veriMppresslAlarm X Other
Project Description/Scope of Work
Project Value
Buildng Area (sq. ft) Parking Garage NA _'• Fk"_A L r Poorer ..37° Fk or
Building Height _NA_
Are there any environmentally sensitive areas located on the panel? `n, a if yes a
completed environmental checklist must accompany perm t application
BUILDING OWNERJTENANT NAME._ C;J of Yc- im t;J9 IC-
ADDRESS c10l K ho{ ov1 'Road _EMAIL t Vsri !e 6- re lm Wo .,t5
CITY YLIM STATF k4I A 71P qS 'TF1 PPwnwi= Ain _ Lf_ Sanf
ARCHITECTIENG1NEER LICENSE #
ADDRESS EMAIL
CITY STATE ZiP TELEPHOh
GENERAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTORS 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 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 taws, rules and regulations of the State of Washington and the
City of Yelm.
Applicant's Signature Date
Owner I Contractor! wren's Agen /Contractor's Agent/ Tenant (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 Yearn Ave W {360) 458 -3838
(360) 458 -3144 FAX
Yelot, WA 98597 rvww.ci.yeirMWa.ua
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Proposed Yelm Skatepark Figure
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Data Source: Esri 2012
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LANDAU Phase I ESA Vicinity Map
ASSOCIATES Yelm, Washington r 1
YELM BUILDING PERMIT APPLICATION
Address:
203 SE I" St, Yelm, WA 98597
Owner of Property:
City of Yelm Public Works
Architect and Phone Number:
Not Applicable
Contractor and Phone Number:
Environmental Consultant (Contractor): Landau Associates, Inc.
Project Manager: Jessica Stone (425) 778 -0907
Site Assessor: Celene Blair (425) 778 -0907
Construction Firm (Subcontractor): Green Earthworks Construction
Project Manager: Jayson Stevens (253) 534 -8202
Site Decommissioner: Justin Weber (253) 534 -8202
Construction Activity:
Excavation and removal of two underground storage tanks (USTs). No structures are being built.
Building Use:
Not Applicable
Legal Description:
Not Applicable
Zone:
Central Business #6
Code:
Not Applicable
Occupancy Group:
Not Applicable
Construction Type:
Excavation
Building Area:
Not Applicable
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