20170255 Permit Pkg 07062017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20170255
Issue Date: 7/06/2017
(Work must be completed within 180 days)
Applicant:
Name: HIEN & LOAN GIANG Phone: 360- 970 -5902
Address: 1925 54TH LN SE
OLYMPIA WA 98501
Property Information:
Site Address: 15343 107TH LP SE Owner: HIEN GIANG
Assessor Parcel No.: 62310000300 Subdivision:
Contractor Information:
Name: HIEN & LOAN GIANG Phone:
Address:
1925 54TH LN SE
OLYMPIA WA 98501
Contractor License No.: Expires: 0 /00 /0000
Project Information:
Project: ROOF
Description of Work: TEAR OFF AND REPLACE WITH NEW ROOF
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
ROOF
Contractor
HIEN & LOAN GIANG
triY�1�1���
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 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 Sta of Washington.
Signature Date / 1
Firm
Lot:
Fees
$ 25.00
$ 25.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
M ~� Vn1N
� �� l��m
(36 458-3244
RECA: 00273935 7/06/2017 2:52 PM
OPER; ASHCO TERN: OOl
HEFA: 1142
PAID BY:
TRAN: 23.0000 BUILDING P(RN1lS
20170255 25.0(CR
GIANG, HIEN 8 LOAN
15343 107TH LP SE
ROOF 25.0(CR
TENDERED: 25.00 [HECK
APPLIED: 25.00-
CHANGE: 0.00
`W
BUILDING PERMIT APPLICATION x(10 9&S
❑ New Construction (SFR) ❑ Remodel
❑ Mechanical
❑ New Construction (Duplex) ❑ Addition
❑ Commercial
❑ New Construction (Multi - family) 57Reroof
❑ Tenant Improvement
❑ Manufactured Home Placement ❑ Plumbing
❑ Fire Permit
Property Address: q 3 0'7 r� L
Tax parcel number: Subdivision:
Lot No.:
Project Description /Scope of Work: Q`�
�(�`� ��'�` V11 4'J i'
Project Value: Heat Source:
❑ Gas ❑ Electric ❑ Solar
Plan No.: Bedrooms: Baths:
Area 1St Floor: 2nd Floor:
3rd Floor:
Garage: Basement:
Carport:
Covered Patio:
Front Porch:
Applicant: C("i G--1A +J Owner:
Address: oq2 S� i( L, sc Address:
&D � l
Telephone: � � �� S `) () Z Telephone:
Email: tt_,,v . �;11-7 Email:
Architect /Designer: General:
Address: License No.:
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 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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