20160294 Permit Pkg 07152016City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: 503 FIRST STREET LLC
Address: PO BOX 2249
YELM WA 98597
Property Information:
Site Address: xm i FIRCT CT C
Assessor Parcel No.: 22719332400
Contractor Information:
Subdivision:
Permit No.: 201 60294
Issue Date: 7/15/2016
(Work must be completed within 180 days)
Phone: 360- 458 -6758
Owner: 503 1 ST ST LLC
Name: 503 FIRST STREET LLC Phone:
Address:
PO BOX 2249
YELM WA 98597
Contractor License No.: Expires: 0 /00 /0000
Project Information:
Project: ROOF
Description of Work: STANDING SEAM METAL ROOF
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor
ROOF 503 FIRST STREET 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 of Washington.
Signature Date
Firm
Lot:
Fees
$ 492.25
$ 492.25
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
07/08/2018 FRI 8!28 FAX
2
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
ProJect Address: S03 /51- 51f. SO- � Parcel #' 22 }l9 33 Z q 00
Zoning;
Current Use: Q C-4c- Proposed Use: 54"1F.
U002/004
0 New Construction XRe -Model R® -Roof 1 Tenant Improvement
❑ Plumbing 0 Mechanical 17 Fire Prevent/Suppress/Alarm ❑ Other d-e- .
/t
Project Description /Scope of Work:_ _. -L 117 E I-4(- RO°� ��✓
Project Value: 0 3`I; GY3.
Building Area (sq. ft) Parking Garage 14- 1e* Floor S2c02n" Floor zS"P Floor $
Building Height
Are there any environmentally sensitive areas located on the parcel?
completed environmental checklist must accompany permit application,
If yes, a
Ell4,>t:lli`1Nr;V S03 /s � - S <L.C_
ADDRESS .40 _(dow 225/9 EMAIL S7XVZa YSro+vL aye
CITY - STATE4,.j./1. ZIP 985-lq 7 TELEPHONE 3G0 - qS8 - G7 5-8
, IRC HI7T, 1'/ { JN R' �^� LICENSE #
ADDRESS_ EMAIL
CITY STATE ZIP TELEPHONE
CffiITRAt'fO sra--ff- &IA-k TELEPHONE 3Go -vS8- 7"
ADDRESS s $a ZZV�% EMAIL -U1"C-
CITY._. yC.A-owt STATE "& ZIP 83-97 FAX 34-0 -- v58
CONTRA OTCTRA OTC R'S LICENSE # KSrrtro "KO EXP DATEAt (CITY LICENSE # /6-2oW/ /
PUUII(MBINQ IMITIRACTOR Na "'e- TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE it
IiIN%�Sl7'7CC?N)C' TELEPHONE
ADDRESS EMAIL _ m
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 laws, rules and regulations of the State of Washington and the
City of Yelm.
—Q
Applicant's Signature Date
Owner /Contractor 1 Owner's Agent/ Contractor's Agent I Tenant (Please circle one.)
All permits are non - transferable and will exDlre If work authorized by such permit Is not begun
within 180 days eriod of 190 days
KEY STONE MASONRY
106 Yelm Ave W
Yedm, WA 98697
S r
teve Foman - President Inc.
BRICK. BLOCK, CUSTOM STONEWORK
MASONRY RESTORATION
oil
(880) 468 -3$36
(360) 468-8144 FAX
wrucu.c d.yelm,.tua. U8
Cite of Yelm
(36 1) 458 -3244
REC #: 00237649
OPER: CO 711512016 1:31 PM REF #: 1364 TERM: 001
PAID BY:
TRAM: 33.0000 BUILDING PERMITS
20160294
503 FIRST STREET LL(
CR
503 FIRST ST S
ROOF 492.ZCR
TENDERED: 492.25 (HECK
APPLIED: 492.25 -
CHANGE: 0.00
City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: 503 FIRST STREET LLC
Address: PO BOX 2249
YELM WA 98597
Property Information:
Permit No.: 20160294
Issue Date: 7/15/2016
(Work must be completed within 180 days)
Phone: 360- 458 -6758
Site Address: 503 FIRST ST S Owner: 503 1ST ST LLC
Assessor Parcel No.: 22719332400 Subdivision: Lot:
Contractor Information:
Name: 503 FIRST STREET LLC Phone:
Address:
PO BOX 2249
YELM WA 98597
Contractor License No.: ,��SCS m a6 K3 Expires: 0 /00 /0000 /Z '� 6
Project Information:
Project: ROOF
Description of Work: STANDING SEAM METAL ROOF
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
ROOF 503 FIRST STREET LLC $ 492.25
TOTAL FEES: $ 492.25
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 St e o ington. -7 /
Signature Date
Firm �` _C—c, J T�Wx- dus. /ty
,S'6,� �l2.sT STS' 44L
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By: