20160405 Permit Pkg 12132016City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: JEFFREY LEMKE
Address: 15209 105TH AVE SE
YELM WA 98597
Property Information:
Site Address: 15209 105TH AVE SE
Assessor Parcel No.: 65080005100 Subdivision:
Contractor Information:
Name: JEFFREY LEMKE
Address:
15209 105TH AVE SE
YELM WA 98597
Contractor License No.:
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.: 20160405
Issue Date: 12/13/2016
(Work must be completed within 180 days)
Phone: 360- 400 -0688
Owner: JEFFREY LEMKE
Lot:
Phone:
Expires: 0 /00 /0000
Heat Type (Electric, Gas, Other):
Contractor
JEFFREY &VICTOR LEMKE
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%hinatQn. > /
Signature Date 6
/�` % `j
Firm ,
Fees
$ 25.00
$ 25.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of y
el
(36 1� 458 -3244
REC#: 00252568
REFF: CO TERM: 001'3/2016 2:5U PM
PAID BY:
BY: :
TRAN: 33.0000
20160405
BUILDING PERMITS
LEMKE 25,p(CR
15209 JEFFREY &VIC10R
105TH
ROOF
AVE SE
RENDERED;
25.0(CR
APPLIED:
25.00 CHECK
25.00 -
C'HANGE: -'" -
---_�
0.00
ASHING
BUILDING PERMIT APPLICATION
❑ New Construction (SFR)
❑ Remodel
❑ Mechanical
❑ New Construction (Duplex)
❑ Addition
❑ Commercial
❑ New Construction (Multi - family)
8 Reroof
❑ Tenant Improvement
❑ Manufactured Home Placement
❑ Plumbing
❑ Fire Permit
Property Address: 15209 105 ave se yelm 98597
Tax parcel number:
Subdivision:
Lot No.:
Project Description /Scope of Work:
re roof
Project Value: $ 5,500.00
Heat Source:
❑ Gas ❑ Electric ❑ Solar
Plan No.: Bedrooms:
Baths:
Area 1st Floor:
2 "d Floor:
3'd Floor:
Garage:
Basement:
Carport:
Covered Patio:
Front Porch:
Applicant:
Owner: Jeff Lemke
D
Address:
Address:
15209 105 ave yelm wa 98597
p
Telephone:
Telephone:
360 - 584 -0575
p
Email:
Email:
Architect /Designer:
General:
Clear View Exteriors LLC.
p
Address:
License No.:
clearve858dk
p
Telephone:
Telephone:
360 - 515 -6920
Email:
Email:
scott@clearviewwa.com
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.