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20160364 Permit Pkg 11232016City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Applicant: Name: EASTHAVEN VILLA Address: c/o BEEHIVE MANAGEMENT FOREST GROVE OR 97116 Property Information: Site Address: 311 CULLENS RD NW Assessor Parcel No.: 21724140502 Subdivision: N/A Contractor Information: Name: HARRINGTON CONSTRUCTION & DEV Address: ANDY PO BOX 1 EAST OLYMPIA WA 98540 Contractor License No.: HARRICD942R8 Project Information: Project: ROOF Description of Work: Sq. Ft. per floor: Fees: Item ROOF TEAR OFF AND REROOF First Second Third Garage Basement Permit No.: 20160364 Issue Date: 11/23/2016 (Work must be completed within 180 days) Phone: 503 - 357 -3793 Owner: TYPE CURRENT OWNER NAME Phone: Expires: 1/01/2017 Heat Type (Electric, Gas, Other): Contractor HARRINGTON CONSTRUCTION & DEV 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. also certify that the proposed structure is in conformity with all applicable City of Yelm regulations incl ing tho a governing zoning and land subdivision, and in addition, all covenants, easements and restr tions o Af applyi as a contractor, I further certify that I am currently registered in the St of h n n. ,w Signature . Date Firm f . Lot: N/A Fees $ 1,066.55 $ 1,066.55 OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: Cite of Mm (36 �) 458 -3244 RECD': 00251002 11/23/2016 6:58 AM OPER: CO TERM: 001 REFS` : 12971 PAID BY: TRAM: 310000 BUILDING PERMITS 20160364 1,066 K CR EASTHAVEN VILLA 311 CULLENS RD NW ROOF 1,066.5`.CR TENDERED: 1,066.55 (HECK APPLIED: 1,066.55- CHANGE: 0.00 BUILDING PERMIT APPLICATION All) (14AA • New Construction (SFR) ❑ Remodel ❑ Mechanical • New Construction (Duplex) ❑ Addition Commercial • New Construction (Multi - family) XReroof ❑ Tenant Improvement • Manufactured Home Placement ❑ Plumbing ❑ Fire Permit 1 Property Address: 311 CUk \kt.�S N Tax parcel number: Subdivision: Lot No.: Project Description /Scope of Work:�� -D�'r' Project Value6w >kLr&G Heat Source: ❑ Gas ❑ Electric ❑ Solar Plan No.: Bedrooms: Baths: Area LK4(:* 1st Floor: 2nd Floor: 3rd Floor: Garage: Basement: Carport: Covered Patio: Front Porch: Applicant: %Y1 UGht6' nw er: /ac�l��oyGE�i Address: Address: on\%`M Telephone: Telephone: Email: Email: iR CXn J't Architect /Designer: .S -X General:,�:«KQS C-0 O-C r° Address: License No.: Lob}c Telephone: Telephone: Email: Email: Q Plumber: Mechanical: Email: Email: NOV 14 2016 License No.: License No.: BY;_ •..•.ww.w•w.w..AAw. By submitting this application to the City of Yelm, you affirm that all answers, statements, and information contained in and submitted with this application are complete and accurate to the best of your knowledge and that you are the owner of the property or duly authorized by the owner to act on their behalf. Permission is granted to representatives of the City to enter upon and inspect the property as reasonably necessary to process the application.