20160221 Permit Pkg 05202016City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: BOBBY WALKER
Address: 10238 THIRD ST SE
YELM WA 98597
Property Information:
Site Address: in9'%R THIRn ST RE
Assessor Parcel No.:
Contractor Information:
Name: BOBBY WALKER
Address:
10238 THIRD ST SE
YELM WA 98597
Subdivision:
Contractor License No.: Expires
Permit No.: 20160221
Issue Date: 5120/2016
(Work must be completed within 180 days)
Phone: 253 - 677 -2148
Owner: BOBBY WALKER
Lot:
Phone:
0 /00 /0000
Project Information:
Project: RESIDENTIAL
REMODEL
Description of Work:
10'X 21' ADDITION W /COMPLETE INTERIOR RENOVATION
Sq. Ft. per floor:
Heat Type (Electric, Gas, Other):
First
Second
Third
Garage
Basement
Fees:
Item
Contractor
Fees
BUILDING
BOBBY WALKER
$ 1,062.18
MECHANICAL
BOBBY WALKER
$ 36.00
PLUMBING
BOBBY WALKER
$ 27.00
TOTAL FEES:
$ 1,125.18
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 Washington. { /
Signature �J a l.�/! Date J ' O ,
Firm
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Nm
(36 ) 458 -3244
REC #: 00232355 5/20/2016 10:09 AM
OPER: CO TERM: 001
REF #: 215
PAID BY:
TRAN: 33.0000 BUILDING PERMITS
20160221 1,125.18CR
WALKER, BOBBY
10238 THIRD ST SE
BLDG 1,062.1ECR
MECH 36.000R
PL 27.0(,-CR
TENDERED: 1,125.18 CHECK
APPLIED: 1,125.18 -
CHANGE: _� 0.00
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: /M3'� 5 RI) sl SF, Parcel #:
Subdivision:
Lot #: Plan #: Zoning:
New Construction >�Re -Model / Re -Roof / Addition Home Occupation Sign
Plumbing X Mechanical Mobile / Manufactured Home Placement Other �6tJpUA���
Project Description /Scope of Work: i0' x Zl IiDDZ -T: nfJ WI .ohAPL , LINIFE22e2
Project Value: so., 0 0 9
Building Area (sq. ft) 1s' Floor 1300 2nd Floor Garage N -6 Deck
Basement Carport
�� Patio
# Bedrooms .3 # Bathrooms % Heating_ S THER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? 00
If yes, a completed environmental checklist must accompany permit application.
BUILDING OWNER NAME: !',i3 Y L k I
ADDRESS i Q�.3 $ _7520 ST nC. EMAIL oR GAS -.
CITY Vi g -t4 STATE t, ILA ZIP X %33 R TELEPHONE ;,5 3 - 677 -- 21 ` T
ARCHITECT /ENGINEER (5:a4 - Fr *ER1iElLG 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 A AGFd2,DP(2;1E. TELEPHONE 36 0 - .270 - X87ti
ADDRESS EMAIL
CITY _STATE Z FAX
CONT CTOR'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.
1 1
Applicant's nature Date
Owner / Con ctor / 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 Auenue West
Yelm, WA 98597
wwwA.yelm.wa.us
(360)
(360)
���U�
4 FAX
• 201
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