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20040123 o o City ofYelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Permit No PL-04-0123-YL Issue Date 12/29/2004 (Work must be started within 180 days) Receipt No 34336 .Applicant: Name Easthaven Villa Phone 458-2800 Address. 311 Cullens Rd. NW City' Yelm State WA Zip 98597 Property Information' Site Address. 311 Cullens Assessor Parcel No 21724140502 Subdivision. N/A Lot: N/A Contractor Information Name CA...) j,0~-vL--- Contact: Phone Address. City' State Zip Contractor License No Expires. Business License. Project Information Project: Easthaven Laundry Room Upgrade Description of Work: Remodel Laundry Room & Kitchen Sq. Ft. per floor' (1 st) 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 3400 $34.00 2000 1400 7 0000 2.0000 Fixture Applicant's Affadavit: 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 thQ.?-!:Lgoverning zO~lng and land'subdlvislon, and in addition, all covenants, easements ~n_d,res~ti8r1sOf reco/d)lf~PPIYlng as a ~ontractor, I futher certify that I am currently registered-Hi the ate of Washiflgtpn. / / ~ /' / .' / ~r~. . _ ,~ / J: c..< C;; G7o/ ~ Firm OFFICIAL USE ONLY # Sets of Prints Final Inspection; Date: By' ~!, ~;lllt,.."\j!\ ClrTV Off,' \. ~"/~1" J1 )1 . I..., . \~, Y'E . ~~ .' ,L.t\1 ~/;::::/<~~' ,P 0 Box 479 ~. ")~/. . n~!,~-'. \l!~ '-'H:\:)q- ,,):E:::JS:.~~ .)C,U 4b.3 B,iO'] RECE~PT No. 3 4. 336 RECEIVED ****THIRTY FOUR DOLLARS & 00 CENTS }=lECEi\'[[" FROI\/1 DATE F-IEC NO P\MOU~~T REF ~IO EASTHAVEN VILLA 311 CULLENS ROAD YELM. WA 98597 PL-04-0123-YL SITE: 311 CULLENS 12/29/04 34336 34.00 CHECK 21680 ! MISCELLANEOUS RECEIPT DIANA - -' -- -- PLMB PRMT 34.00 o Applicant: Name Easthaven Villa o City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Address 311 Cullens Rd NW City' Yelm Project Information Project: Easthaven Laundry Room Upgrade Description of Work: Remodel Laundry Room & Kitchen Site Address 311 Cullens Fees Item Plumbing Permit Acct Code Item Fee o Permit Fees Schedule Permit No PL-04-0123-YL Phone 458-2800 State W A Zip 98597 Assessor Parcel No 21724140502 Unit Rate No Units Unit Desc 7 0000 2.0000 Fixture 032001-322-10-00 3400 Base Amt Unit Fee 2000 1400 TOTAL FEES $34.00 I r () -- '-....-/._~"_. . -------..--.......-- n '~"'" EX' ~Sllhi6 WA"':$TE C R:l:;, 1;, r1 2.i~ ~VID a.~LT8?"/Af<C~/TEGT 1.737 WO~p ~DR~\W i YELM I WA OLytytPIA,.WA ~B50"2-,u~-- ..- ---,---' ! ""t":: I . 'T c::?"'-V'"'\l... '/.::::..-r-/'\OJ'.r:'~E Rr-:Vla....l(. ,J""~':; !""\L1. 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I'" ", 0 j II" 1/ h 11,,)\\ \ \\ll \l\ \\ \ 1 m)))) .,..1>1"'''''' 0 RECEIVED JUL 22 2004 Project Address: CITY OF YElM COMMERCIAL BUILDING J:lERMli ~-\LICATJON FORM e l tJCUrceI#' ).17:lt.\l ~t> ~D'L-- Zoning, Current Use, Proposed Use o New Construction If Re~Modell Re-Roof r T anent Improvement )( Plumbing 0 Mechanical 0 Fire Prevent/Suppress/Alarm 0 Other , Project Description/Scope of Work:J~~rtA.ll lA.Ja~~eK ~~fr:1' Al:l:;k,~ U,DJ , dt ...::s~ - Rc:..~ wo.-W tiJ t<: I id.(!..~' Project Value' ~ ~ ~ Building Area (sq. ft) Parking Garage 151 Floor 2na Floor 3rd Floor_ Building Height A/_ Are there any environmentally sensitive areas located on the parcel? ~ completed environmental ohecklist must accompany permit application. If yes, a 1LJ{ I ~ r~ 1Jrf"; "J J" ll'~'\ Bu;iC::b ~G:;OW'., , .'''''. ' J, """,___ ADDR S CITY ~...B.lm.~Gji~~~H~!.~g." - ~ LICENSE # ADDRESS ~7 3"1 w w~ DR.. ~~ CITY Ol - STATE (,U~ ZIP qf>.:-~'7- TELEPHONE.5{pO Ii!.Co(p ~93~ !~~~C~:AT~WNf:P_~,t- :~PH:/~ 'I 1 ~ 1~i,i~PI~O'f ! CONTRACTOR'S LICENSE #tAP<<rz. Lq{,~P DATE CITY JCENSE # , p!-uMSiNG:,GCiNTRActqR TELEPHONE ADDRESS. CITY STATE ZIP FAX Cm,ITRACTOR'S LICENSE # EXP DATE CITY LICENSE # MECHANICA~ CONTRAC.TOR ~l)u.)~~ __TELEPHONE ADDRESS CITY ST ATE:___ZIP ~FAX. CONTRACtOR'S LICENSE # EXP DATE CITY LICENSE # - J Copy of City MitigatIon documentaticn (TFC), pplicant's Signature Owner I Contractor I Owner's Agent / 5<-~~' Date (Please circle one.) All permits are non-transferable and will expire if work authorized by such permit is not begun within 180 days 01 issuance, or If work is suspended or abandoned for a period of 180 days tin!) 7rln d fj lvli:l v17l' %17 o~s A3G NHOJ-Nl3A ~O All] In il ~nO~-Gn-13G