20150229 Permit Pkg 07062015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: C & E DEVELOPMENT LLC
Address: PO BOX 2983
YELM WA 98597
Property Information:
Site Address: 10110 WEST RD SE
Assessor Parcel No.: 64303601600
Contractor Information:
Name: C & E DEVELOPMENT LLC
Address: ERIC PETERSON
PO BOX 2983
YELM WA 98597
Contractor License No.:
Project Information:
Project: ROOF
Description of Work: REROOF. DRIP EDGE FLASHING REQUIRED
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Permit No.: 20150229
Issue Date: 7/06/2015
(Work must be completed within 180 days)
Phone: 253 - 278 -0343
Owner: ERIC PETERSON
Subdivision: Lot:
Phone:
Expires: 0 /00 /0000
Fees:
Item
ROOF
Contractor
C & E DEVELOPMENT LLC
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 State oilvv,20ngton.
Signature_ � Date
4,31
Firm
Fees
$ 25.00
$ 25.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City Of m,
(36 ) 458 -3244
REC #: 00199790 7/06/2015 2:28 PM
OPER: CO TERM: 001
REF #:
PAID BY:
TRAN: 33.0000 BUILDING PERMITS
20150229 25.000R
C & E DEVELOPMENT LLC
10110 WEST RD SE
ROOF 25,OOCR
TENDERED: 25,00 CASH
APPLIED: 25,00-
CHANGE: ___
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CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: ' 0 5L Parcel #:
Subdivision: Lot #: Plan #: Zoning:
New Construction X Re -Model / Re -Roof / Addition Home Occupation Sign
Plumbing Mechanical Mobile / Manufactured Home Placement Other
Project Description /Scope of Work: hs , S li'+✓�?v, ,
Project Value:
Building Area (sq. ft) 1s` Floor 2r6 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?
If yes, a completed environmental checklist must accompany permit application.
BUILDING O�v NI N IL fiG1r50n
ADDR SS YD EMAIL IiYI 0 ►vi
CITY P,I WI STATE_WA_ZIP g 1 TELEPHONE S3 to$ - !oZ
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR TELEPHONE
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 gnature 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 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.yelm.w¢.us