20170287 Permit Pkg 08152017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: GEORGE CASTAGNO
Address: 109 MOSMAN AVE SE
YELM WA 98597
Property Information:
Site Address: 1f1Q M(1CMAA1 AVF CG
Assessor Parcel No.: 22719331300 Subdivision:
Contractor Information:
Name: GEORGE CASTAGNO
Address:
109 MOSMAN AVE SE
YELM WA 98597
Contractor License No.:
Permit No.: 201 70287
Issue Date: 08115/2017
(Work must be completed within 180 days)
Phone:
Owner: GEORGE CASTAGNO
Phone:
Expires: 0 /00 /0000
Project Information:
Project: BUILDING
Description of Work: MOVE IN ACCESSORY 12 X 12 BLDG.
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
BUILDING
Contractor
GEORGE CASTAGNO
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 corr t. I als certify that the proposed structure is in conformity with all applicable City of
Yelm regulations i lu n those governing zoning and land subdivision, and in addition, all covenants,
easements nd re is of record. If applying as a contractor, I further certify that I am currently
registered in the S t ashington.
O
Signature Date 6 —t�" l�
Firm
Lot:
Fees
$ 38.75
$ 38.75
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By
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8/15x2017 :48 PM
RECD:
UPEF': CO TERM:
001
REFS ,
PAID By''
3 3,0000
BUI[D138 Pr R13
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0170287
CASTAGNO,
GEORGE
109 MOSMAN AVE SE
7`.CR
E'XDG
IE.NDERED:
40.00 (ASH
APPLIED:
38,75-
OR
BUILDING PERMIT APPLICATION &0170 oV7
❑ New Construction (SFR) ❑ Remodel
❑ Mechanical
❑ New Construction (Duplex) ❑ Addition
❑ Commercial
❑ New Construction (Multi - family) ❑ Reroof
❑ Tenant Improvement
❑ Manufactured Home Placement ❑ Plumbing
❑ Fire Permit
Property Address: CD �5 M�U
< I UAL S(z ,
Mwt t Vie_
i zx /2-
Tax parcel number:
Subdivision:
Lot No.:
Project Description /Scope of Work:
Project Value: 02c, —
Heat Source: ❑ Gas
❑ Electric ❑ Solar
Plan No.: Bedrooms:
Baths:
Area 1st Floor:
2nd Floor:
3rd Floor:
Garage:
Basement:
Carport:
Covered
Front Porch:
�� yyPatio:
Applicant: ribf�r'i X13 Py 6
v Owner:
Address: ( 0A10) k-'Jv ° I [
Si- Address:
*F' CA,
V�A `
Telephone: y� q _3 qq (
t
Telephone:
Email:
�
a q �T�qL
Email:
A,,--
Architect /Designer:
General:
Address:
License No.:
Telephone:
Telephone:
Email:
Email:
Plumber:
Mechanical
`� 6 2017
Email:
Email:
License No.:
License No.:
BY. ....................
b/ 1
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.