20170290 Permit Pkg 08172017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: T- MOBILE
Address: 1202 YELM AVE E
YELM WA 98597
Property Information:
Site Address: 1202 YELM AVE E D
Assessor Parcel No.: Subdivision:
Contractor Information:
Name: T- MOBILE
Address:
1202 YELM AVE E
YELM WA 98597
Contractor License No.:
Permit No.: 201 70290
Issue Date: 8117/2017
(Work must be completed within 180 days)
Phone:
Owner: T- MOBILE
Phone:
Expires: 0 /00 /0000
Project Information:
Project: COMMERCIAL REMODEL
Description of Work: REMOVE EXISTING WALLS FOR SHOW ROOM
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Lot:
Item Contractor Fees
BUILDING T- MOBILE $ 530.06
MECHANICAL T- MOBILE $ 20.00
TOTAL FEES: $ 550.06
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 Stpf Washington
Signatur(EL Date
Firm
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Citj of Yelt
(361) 458-3244
RECh: 00279030
811712017
OPER: Co
RE: 3442 TERM- 001 12: 56 PM
PAID BY:
TRAM: 33.0000 BUILDING PIRMIT"
20170290 550,0tCR
T-MOBILE
BLDG 1202 YELM AVE E 0
MECH 530,0tCR
20.0(CR
TENDERED: 550,06 (HECK
APPLIED: 550.06-
CHANGE:
0.00
CITY OF YELM A
�/h190 010
COMMERCIAL BUILDING PERMIT APPLICATION FORM WV 190
ProjectAddress:12-0Z- tF %1M Av&#MG7 Parcel #: ZZ13010 D'7�.
Zoning; ( Current Use: L� Proposed Use: C'
New Construction Re-Model/Re-Roof enant Im rovem
Plumbing Mechanical Fire Prevent/Suppress /Alarm Other
Project Description /Scope of Work: Eiltsr WA-Lt_es 54 <44�Vcv^A
Project Value: 241 000
Building Area (sq. ft) Parking Garage 1" Floor 2nd Floor 3`d Floor
r
Building Height (_
Are there any environmentally sensitive areas located on the parcel? �= If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER/TENANT NAME':
ADDRESS 17.540 EMAIL - &
CITY ('J�WA1 STATE _6�ZIP Q TELEPHONE U O
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERALCONTRAC OR 1a s�+ TELEPHONE f Q�'I
ADDRES S Q270 1�.6�'T EMAIL C106v b G%0 —L-LC- #40^A
CITY A � STATE'^ ZIP !Z-! i f' FAX y /
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
Copy of City Mitigation documentation JFC).
I hereby certify that the above information is correct and that the construction on, and the occupancy and the use ofthe
above described property will be in accordance with the laws, rules and regulations ofthe State of Washington and the
City ofYelm.
Applicant's Sig." e Date
Owner / ontracto wner's Age 1;' Contractor's Agent /Tenant (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 peri 84h+=59TT
AUG �1 4 2017
(36P,1156- 38-319- ••• - - -- - - - --
105 Yelm Ave W (360) 458 -3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us