1991 Plumbing Permits
TOWN OF YELM PLUMING PERMIT
P.O. Box 479
Yelm, Washington 98597 Separate application for each structure (fir' ~ ~ d ~;
~ ~, ~ ,
Telephone (206) 458-3244
Datt fc~,'~`=~
Const. Addr4 s %~~1/ ~~i'T~="w,~ ~ ~-' sCc-) Occupancy ~~~"'•~ ~~= ~,r'1 ir; ,' it+ i"'; ,%- ~-, ; ,,- ,
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Owner ~~% w ! ~:~ ~ ~ i t ./-' ~ Address Phone
Contractor ~~~ ~ %`Jf% ~ ~ f" ~ ? Address_ ~ 'C~~Y (~~'.`' -Phone 1 ~ L~- °'`' ~~ ~~
State Contrs. No. Building Permit Number ~ *1 ~'~~~ CO
ITEM FEE QUAN. FEE
Toilets - ~,, d,~ , /:G.~
Urinals
Lavatory ~'; , n,j ~ /~, p j;
Bath Tubs
Shower Baths /, . ;~ ~
Kitchen Sink `~
(~~ i ~ O
~
h. ~'~
Disposal Units
Dish Washers ~7 ,(j~) O
Drinking Fountains
Laundry Tub
Automatio Laundry Equip, f., (1 (1 ,,. ~)
Catch Basin
Floor Drains
Floor Sink
Tanks
iHot Water ~; ~`~ J ~/„'")'v
/}
Misc. ~ ~ 'l/./rl/~ ~~ ,~ . ~~ ;i ..;. C,~()
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MISC. ~ `,;'1: 'T.;;' /;:;~' /n.~ ~.:~ : l C4) ~. (~ L,).
~`_~~~,,/..,;~t; ~t Permit Fee l.,,ur''Q
~:~J .~ ~~ :,~ TOTAL ENCLOSED FEE ~~. ~)(~l
DESCRIPTION OF WORK
New
Addition
^ Remodel
^ Alteration _-
CONTRACTOR'S AFFIDAVIT
I hereby make application for a Plumbing permit and cer-
tify that our firm is registered as a contractor with the
State of Washington and Town of Yelm and that work
shall be performed in accordance with all Codes and Or-
dinances of Town of Yelm.
Firm ~~~(~~ G~ ~"~.~ r1,~r, i.. .;! C':~~ "~_
Signature ~° ~-~} ~~ '~-
No work shall be performed prior to receipt of validated
permit. Call 458.3244 for inspection.
FOR TOWN OF YELM USE ONLY
~~
4
Recd. by -~--~-~J•~-------------------- Date r='i ~' ==-~? • ~~• ~---- Permit tF ~~` :~ ~ -1~L
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