20160333 Permit Pkg 09222016City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20160333
Issue Date: 9/22/2016
(Work must be completed within 180 days)
Applicant:
Name: MARK & CYNTH DESCHENES Phone: 337 - 540 -2427
Address: 9022 ANDES CT SE
YELM WA 98597
Property Information:
Site Address: 9022 ANDES CT SE Owner: MARK DESCHENES
Assessor Parcel No.: Subdivision:
Contractor Information:
Name: MARK & CYNTH DESCHENES Phone:
Address:
9022 ANDES CT SE
YELM WA 98597
Contractor License No.: Expires: 0 /00 /0000
Project Information:
Project: RESIDENTIAL ADDITION
Description of Work: UPPER AND LOWER DECK
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
BUILDING
Contractor
MARK & CYNTH DESCHENES
TOTAL FEES:
Applicant's Affidavit: ✓
I certify that I have read and apned the im/Irmation contained within the application and know the same
to be true and correct. I als4rdertify that the proposed structure is in conformity with all applicable City of
Yelm regulations includiR�thase governing zoning and land subdivision, and in addition, all covenants,
easements and restrictions of record.}I.,applying as a contractor, I further certify that I am currently
registered in the State of aching,
(( ' tZ-2 6
Signature /� J' Date
Firm /
Lot:
Fees
$ 414.56
$ 414.56
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City► of Yelm
(36)) 458 -3244
RECA': 00244740 9/22/2016 2:52 PM
OPER: CO TERM: 001
REF #:
PAID BY:
ACCT #: XXXXXXXXXXXXXXXXXXX
AUTH #: 092217
TRAN #: 000000002596
TYPE:: PURCHASE
TRAM: 33.0000 BUILDING PERMITS
20160333 414.5ECR
DESCHENES, MARK & (YNTFI
9022 ANDES CT SE
EiLDG 414.5E CR
TENDERED: 414.56 CREDIT CARD
APPLIED: 414.56-
CHANGE: 0.00
201f 0 3 33
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address:DZZ- Mbf-5 urs16 Parcel #:
Subdivision: Lot #: Plan #: Zoning:
11 New Construction Re -Model / Re -Roof / Addition Home Occupation Sign
_l Plumbing Mechanical ,Mobile / Manufactured Home Placement N Other
Project Description /Scope of Work: DECK 4 I)-69L c-L -ei—
Gi
Project Value: S_ ODD .
Building Area (sq. ft) 1" Floor 2"' Floor }l-W 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: C
ADDRESS 9 7-7 AND 6 S rr '50 EMAIL
CITY !JELM STATE VVA ZIP 7i /- TELEPHONE 3 6 O - 3S9 - 86 I C%
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL,CONT TOR C TELEPHONE b -
ADDRESS EMAIL kVRIC47' 6gA69e L�U1i71ei9f j� s
CITY_ STATE 1v/ ZIP `) FAX
CONTRACTOR'S LICENSE # LEXP 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 ag.eement with Yelm Community Schools, if applicable.
I hereby certify ove inf rmation is correct and that the construction on, and the occupancy and the use of the
above descri d will b in accordance with the laws, rules and regulations of the State of Washington and the
City of Yel
A B/zl I //I -,?
App Iica a Date/
Owner Contract 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.wa.us
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