1995 Mechanical Permits. ~ .,
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TOWN OF YELM MECHANICAL PERMIT -
P.O. Box 479
Yelm, Washington 98597 ~ 5 2 ~ ~
Telephone (206) 458-3244 Separate application for each structure C,
~ ~ 7 Date ~.~ ~ - /.
Const. Address `~~~~ ~~~~~_ ~ ~ ~ Occupancy ~ y~~-l ~Q~p~ a
Owner~~'~'T/If~/l'9, -/f1'L..~-a~~ //Il°~• Address9.xC~Z~/J1-~'t'I.~~1~~~v.~f.~' Phone./i~~~~~li-'
Contractor ~ ~~~-~ ~ Address Phone
State Contrs. No.~~~/1+~~-x~~~~? Building Permit Number .~`~ ~~
i x~ Under 100,000 BTU Fee $ ,
®Hot Air Furnaces /~ 9 Permit ^ Gas ^ Oil ^ Electric ^ Others
^ Over 100,000 BTU Fee $
^ Under 100,000 Fee $
^ 100,001 - 500,000 Fee $
^ Hot Water ^'500,001 - 1,000,000 Fee $ CONTRACTOR'S AFFIDAVIT
or Steam Boiler ^ 1,000,001 - 1,750,000 Fee $ I hereby make application for a Mechanical Permit and
^ Over 1,750,000 Fee $ certify that our firm is registered as a contractor with the
St t f Washin ton and Town of Yelm and that work
^ Air Handling Units ^ Under 10,000 CFM Fee $
^ Over 10,000 CFM Fee $
^ Evaporator Coolers (Not portable) Fee $
^ Repairs or alterations to an~y/of the above Fee $
X^, Vent or Vent Fan (not covered by other permit Fee $
~^~'~ Exhaust Hood Fee $
~~ ^ Domestic Fee $
Incinerators
^ Commercial Fee $
/~ Other Appliances (IistlltJ/f8[.~ t','QL@~E F/}fU Fee $
'd Other Mechanical Installations (Iist16A5 AIPIl~I~ By Value
/I~` ~~~~pl, Permit Fee
TOTAL ENCLOSED FEE 7 ~rJ~I
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shall be performed in accordance with all Codes and Or-
dinances of Town of Yelm.
Firm A ,~,~-__T~?'1 /5'rtl C~Jff1S/. ~fU C-
Sign ture (JC-.~~.C~//~r/ ~S'G- rS
No work shall be performed prior to receipt of validated
permit. Call 458-3244 for inspection.
FOR TOWN OF YELM USE ONLY
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Recd. byr _ .,, .... [Date ~/.~.~--I 1Permit #
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