20170311 Permit Pkg 09082017City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: MICHAEL AND UTE GIER
Address: CMR 411 BOX 5974
APO AE 09112
Property Information:
Site Address: 9235 BRENDAN DR SE
Assessor Parcel No.: 55360003800 Subdivision:
Project Information:
Project: ROOF
Description of Work:
Sq. Ft. per floor:
First
Second
Third
Garage
Basement
Fees:
Item
RESIDENTIAL ROOFING
Permit No.. 20170311
Fee Calculation Worksheet
Phone:
Owner: TYPE CURRENT OWNER
NAME
Heat Type (Electric, Gas, Other):
Units
1
TOTAL FEES:
PAYMENTS MADE:
BALANCE DUE:
Lot:
$ 25.00
$ 25.00
$ 0.00
$ 25.00
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 'Rr�'SS 101^ S�_ Parcel #: 'S1S3(_0o0b. 3a nb
Subdivision: Lot #: Plan #: Zoning:
New Construction Re -Model a -Roo Addition Home Occupation Sign
Plumbing Mechanical Mobile / Manufactured Home Placement Other
Project Description /Scope of Work: oc-
Project Value: � %6 bU U
Building Area (sq. ft) 1 sc Floor jjoq } 2 "d Floor 3d Floor Garage -2 car(057,3 car
Covered Patio Covered Porch 6th Patio Deck c:�'VG
# Bedrooms # Bathrooms Heatin : GA /OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel ? /Uy
If yes, a completed environmental checklist must accompany permit application.
BUILDING OWNER NAME: KUf- `� ffX
ADDRESS Clot R -111 ' S 4 EMAIL LA ",e r v 1t✓i�ci,1.Cunt
CITY a' STATE ZIP �2 TELEPHO
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CQNT CTOR Sk' V\$ i.((_TELEPHONE� L -`�4E qZ3�..
ADDRESS }"O EMAIL
CITY L� k STATE C ZIP FAX
CONTRA LICENSE # 1 J�(!;_ `i RL9ArMP DATE41JCITY LICENSE # I-±"lo`i I -
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 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.
Ap l# ant's Signature Date
O er / Contractor / Owner's Agent (6ontractor'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
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.yelm.wa.us