20160384 Permit Pkg 12052016ok Jae A City of Yelm
q Community Development Department
4
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: LILIA & ROJAS BAHENA
Address: 413 WASHINGTON AVE SW
YELM WA 98597
Property Information:
Site Address: A11 WACHIAIrZTr)M AVF CW
Assessor Parcel No.: 75300500200 Subdivision:
Contractor Information:
Name: LILIA & ROJAS BAHENA
Address:
413 WASHINGTON AVE SW
YELM WA 98597
Contractor License No.:
Project Information:
Project: RESIDENTIAL ADDITION
Description of Work: TOOL SHED ADDITION
Sq. Ft. per floor: First
Second
Third
Garage
Basement
Fees:
Item
BUILDING
Permit No.: 20160384
Issue Date: 12/05/2016
(Work must be completed within 180 days)
Phone: 360- 481 -0714
Owner: LILIA BAHENA
Lot:
Phone:
Expires: 0 /00 /0000
Heat Type (Electric, Gas, Other):
Contractor
LILIA & ROJAS BAHENA
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 Wa i ton.
Signature /` Date / )
Firm
Fees
$ 63.93
$ 63.93
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of Yolm
(36 i) 458 -3244
RECK 00251684 12/05/2016 3:23 PM
OPER: CO TERM: 001
REFK
PAID BY:
ACC1 #: XXXXXXXXXXXXXXXXXXX
AUTH #: 091174
TRAN #: 000000003443
TYPE:: PURCHASE
TRAM: 33.0000 BUILDING PERMITS
20160384 63 K CR
BAHENA, LILIA & ROJAS
4T3 WASHINGTON AVE EW
BLDG 63.9!CR
TENDERED: 63.93 (REDIT CARD
APPLIED: 63.93-
CHANGE: 0.00
a�
BUILDING PERMIT An
❑ New Construction (SFR) ❑ Remodel
❑ Mechanical
❑ New Construction (Duplex) ❑ Addition
❑ Commercial
❑ New Construction (Multi - family) ❑ Reroof
❑ Tenant Improvement
❑ Manufactured Home Placement ❑ Plumbing
❑ Fire Permit
/
Property Address: x/13 Wo6k'IX34,q -*Ile ye11Ll % ��9
Tax parcel number: 1 Sip o 500,200
Subdivision:
Lot No.: '3
Project Description /Scope of Work:
Project Value: PC.
Heat Source:
❑ Gas ❑ Electric ❑ Solar
Plan No.: Bedrooms:
Baths:
Area 1s' Floor:
2nd Floor:
3rd Floor:
Garage:
Basement:
Carport:
Covered Patio:
Front Porch:
Applicant: ,'� ��
Owner:144.� - ,ea'CK
Z-113 alas -4,n5 m #IV e-
Address:
l�Address:
111E I,nge �
/ e 104 ww �l� 5
Y-el'o" 14r q l
Telephone: 2���O'�� S
Telephone:
Email:
Email:
Architect /Designer:
General:
�/�
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Address:
t 13 wtxs'�' Q
License No.:
s °�
Telephone: y /
Telephone:
Email:
Email:
Plumber:
Mechanical:
Email:
Email:
License No.:
License No.:
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.
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