20170132 Permit Pkg 02212017Yoic THEp
City of Yelm
4 �+
Community Development Department
Building Division
Phone: (360) 458 -8407
L
Fax: (360) 458 -3144
Applicant:
Name: JERRY /ERIN PRICE
Address: 16228 PRAIRIE CRK LP SE
YELM WA 98597
Property Information:
Site Address: 16228 PRAIRIE CREEK LP SE
Assessor Parcel No.:
Contractor Information:
Name: JERRY /ERIN PRICE
Address:
16228 PRAIRIE CRK LP SE
YELM WA 98597
Contractor License No.:
Subdivision:
Permit No.: 20170132
Issue Date: 2/21/2017
(Work must be completed within 180 days)
Phone: 360- 400 -1547
Owner: JERRY PRICE
Lot:
Phone:
Expires:
Project Information:
Project: RESIDENTIAL REMODEL
Description of Work: REPLACE SIDING ON FRONT OF THE GARAGE
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
BUILDING
Contractor
JERRY /ERIN PRICE
TOTAL FEES:
Applicant's Affidavit:
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 tho a governing zoning and land subdivision, and in addition, all covenants,
easements and r strictions o ecord. If applying as a contractor, I further certify that I am currently
registered in `e tate of W ngton.
Signature Date ?j
Firm
Fees
$ 83.25
$ 83.25
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Git of Yelm
(36 i) 458 -3244
RECD': 00260568 2/21/2017 10:13 AM
OPER: CO TERM: 001
REFS`: 14078
PAID BY:
TRAN: 33.0000 BUILDINNG Z[CRI1'3
20170132
PRICE, JERRY /ERIN
16228 PRAIRIE CREEK P -
6LDG
1ENDERED: 83.25 CHECK.
APPLIED: 83.25 -
CHANGE: 0.00
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 16228 Prairie Creek Loop SE Parcel #: 69240004200
Subdivision: Prairie Creek
Lot #: 42 Plan #: NSA Zoning. R -6
� 17a13�
New Construction X Re -Model / Re -Roof / Addition Home Occupation Sign
Plumbing Mechanical Mobile / Manufactured Home Placement Other
Project Description /Scope of Work: replace siding on front of the garage
Project Value: $2044
Building Area (sq. ft) 1" Floor 2nd Floor.
Covered Patio Covered Porch
# Bedrooms # Bathrooms
3rd Floor Garage -2 car 3 car
Patio Deck
Heating: GAS /OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? no
If yes, a completed environmental checklist must accompany permit application.
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable.
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.
Appficant, Sigdatdre Date
`Owner I Contractor 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
Yelyn, WA 98597 (360) 458 -3144 FAX
www.ci.yelm.wa.us