20160247 Permit Pkg 06142016two
City of Yelm
wa,r
o
Community Development Department
Building Division
Phone: (360) 458 -8407
YEL
Fax: (360) 458 -3144
Applicant:
Name: VERNAL GARRIS
Address: 15134 CARTER LP SE
YELM WA 98597
Property Information:
Site Address: 1411A rAPTFP I P SF
Assessor Parcel No.: 52920005500 Subdivision:
Contractor Information:
Name: HOME DEPOT AT HOME SERVICES
Address:
140 COUNTY LINE ROAD #140
PACIFIC WA 98047
Contractor License No.:
Project Information:
Project: ROOF
Description of Work:
Sq. Ft. per floor:
Fees:
Item
ROOF
Expires:
Permit No.: 20160247
Issue Date: 6/14/2016
(Work must be completed within 180 days)
i . NT- . 116% %1iII:I:M:1
Owner: VEMAL GARRIS
Phone:
Lot:
REPLACE 17 SQ COMP ROOFING WITH 2 SKYLIGHTS, NO PLYWOOD REPLACEMENT
First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Contractor
HOME DEPOT AT HOME SERVICES
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 of Washingtgn. j If _ _ A
Firm
Fees
$ 25.00
$ 25.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of Y�lm
(36 1 ) 458 -3244
REC #: 00234475 6/14/2016 2:38 PM
OPER: GI TERM: 001
REF #: 10279
PAID BY:
TRAM: 33.0000 BUILDING PERMITS
20160247 25.000R
GARRIS, VERNAL
15134 CARTER LP SE
ROOF 25.00CR
TENDERED: 25.00 CHECK
APPLIED: 25.00-
CHANGE: 0.00
z�00W`7
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 15134 Carter Loop SE Parcel V. 52920005500
Subdivision: Lot #: Zoning;
❑ New Construction rfl Re -Model / Re -Roof /Addition ❑ Home Occupation Sign
❑ Plumbing ❑ Mechanical ❑ Mobile / Manufactured Home Placement ❑ Other
Project Description /Scope of Work: Replace 17 sq. comp. roofing and 2 skylights; no plywood replacement
Project Value: $11712.20
Building Area (sq. ft) 1" 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? If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER NAME: yemal Garns
ADDRESS 15134 carter Loop SE EMAIL
CITY YELM STATE WA ZIP 98597 TELEPHONE 3607897170
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR Home Depot At Home Svcs. TELEPHONE 800- 381 -5699
ADDRESS 3600 Lind Ave Sw #150, EMAIL
CITY RENTON STATE WA ZIP 98057 FAX
CONTRACTOR'S LICENSE # HOMED "972RQ EXP DATE 2/17 CITY LICENSE # 001419.0
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 Signature ate
Owner / Contractor / Owner's Agent / Contractor's Aaertf (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
PO Box 479 (360) 458 -3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us