20170158 Permit Pkg 03312017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: LORI UHLER
Address: PO BOX 1409
YELM WA 98597
Property Information:
Site Address: l nr %ni rPF=PK AT SF
Assessor Parcel No.: 69280000100
Contractor Information:
Name: LORI UHLER
Address:
PO BOX 1409
YELM WA 98597
Contractor License No.:
Permit No.: 20170158
Issue Date: 3/31/2017
(Work must be completed within 180 days)
Phone: 253 - 686 -6138
Owner: LORI UHLER
Subdivision: PRAIRIE PLAZA Lot:
Phone:
Expires: 0 /00 /0000
Project Information:
Project: COMMERCIAL REMODEL
Description of Work: CONSTRUCTION OF INTERIOR WALLS
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
BUILDING
Contractor
LORI UHLER
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 )Washington.
Signature '� J "��� 1 Cl ': Date -" I -CL
Firm
Fees
$ 114.26
$ 114.26
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
`jt�, of Mi
36i) 458 -3244
EC #: 00264041 3/31/2017 2':41 PM
'ER: AS TERM: 001
-4:
IID BY:
CT' #: XXXXXXXXXXXXKXXXXXX
TH #: 404213
AM #: 000000004788
'E:: PURCHASE
IN: 33.0000 BUILDING PIRMITS
20170158 114.2fCR
UHLER, LORI
10501 CREEK ST SE
BLDG 114.2E CR
TENDERED: 114.26 (REDIF CARD
'IPPLIED: 114.26 -
:HANGE: 0.00
Sq. Ft. per rioor. rirsi
Second
Third
Garage
Basement
Fees:
Item
BUILDING PERMIT ESTIMATED VALUE
BUILDING PLAN REVIEW
Im
!velopment Department
ion
.58 -8407
-3144
Permit No.: 201 70158
Fee Calculation Worksheet
Phone: 253 - 686 -6138
ST SE Owner: LORI UHLER
1 Subdivision: PRAIRIE PLAZA Lot:
DEL
'ION OF INTERIOR WALLS
Heat Type (Electric, Gas, Other):
Units Fees
1,500 $ 69.25
0 $ 45.01
TOTAL FEES: $ 114.26
PAYMENTS MADE: $ 0.00
BALANCE DUE: $ 114.26
BUILDING PERMIT APPLICATION
s
❑ New Construction (SFR) YRemodel
❑ Mechanical
❑ New Construction (Duplex) ❑ Addition
❑ Commercial
❑ New Construction (Multi- family) ❑ Reroof
❑ Tenant Improvement
❑ Manufactured Home Placement ❑ Plumbing
❑ Fire Permit
Property Address: t Q$^01 C -7 yV h'l Wf} qBSq
Tax parcel number: 1og2200007Do
Subdivision:
Lot No.:
Project Description /Scope of Work:
Project Value i,SGO.
Heat Source:
B Gas ❑ Electric ❑ Solar
Plan No.: Bedrooms:
Baths:
Area 1St Floor:
2nd Floor:
3rd Floor:
Garage:
Basement:
Carport:
Covered Patio:
Front Porch:
Applicant: LZrl yYj J� ,hk�r
Owner:
NHS T_jiC,
Address: POE lyoq
Address:
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I,�tr����17
I✓ast 0lk�p %Q- W Jq�f0
Telephone: (S3(1996 (0139
Telephone:
Email: (mn V 'I 1'rt @ Qgjqpt), Uh)
Email:
Architect /Designer:-
�A
General:4r9445 pa`416+Fj c n
Address:
License No.:
A 1vpf?EP it 8 gyi9l
Telephone:
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 y ,err ,- a
that you are the owner of the property or duly authorized by the owner to act on their be ion is
granted to representatives of the City to enter upon and inspect the property as reasonably n ssary to ptoees2oll
the application.
BY: ---------- - - - - --
Pole I!f vq C t9 s4- --W- -7 c� P00,nS
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