20050553 Permit Pkg 050406~oF THFa City of Yelm
a ~ Community Develo
Building Division
Phone: (360) 458-8407
LM Fax: (360) 458-3144
Applicant:
Name: Sunset Air
Address: 5210 Lacey Blvd.
Property Information:
Site Address: 104 Stevens Avenue NE
pment Department
City: Lacey
Assessor Parcel No. 64421500100 Subdivision
Permit No: M-05-0553-YL
Issue Date: 05/04/2006
(Work must be started within 180 days)
Receipt No: 41859
Phone: 360.456.4956
State: WA Zip 98503
Lot:
Name: Applicant Contact: Phone:
Address: City: State: Zip:
Contractor License No: Expires: Business License:
Project Information:
Project: Yelm Education Assoc. A/C
Description of Work: Install 5-ton air conditioner
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0
Heat Type (Electric, Gas, Other): OTHER
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Mechanical Permit 29.50 _ 0.00 0.00 0.0000 0.0000 v~
TOTAL FEES: E29.50
Applicant's Affadavit:
I certify that I have read and examined the information contained within the application and know the same OFFICIAL USE ONLY ~
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of # Sets of Prints:
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 futher certify that I am currently
registered in the State of Washington. ~ ~ Final Inspection:
Signature Date y - O /w Date:
Firm -~ r~ By:
aF T~ City of Yelm Permit Fees Schedule
Community Development Department
P
AID Permit No: M-05-0553-YL
Building Division
Phone: (360) 458-8407 MAY - 4 7nnF
Fax: (360) 458-3144
CITY OF YELM
Applicant: ~ -
Name: Sunset Air Phone: 380.456.4958
Address: 5210 Lacey Blvd. City: Lacey State: WA Zip 98503
Project Information:
Project: Yeim Education Assoc. A/C
Description of Work: Install S-ton air conditioner
Site Address: 104 Stevens Avenue NE Assessor Parcel No. 64421500100
Fees:
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unft Desc
Mechanical Pertnft 032 001-322-10-00 29.50 0.00 0.00 0.0000 0.0000
TOTAL FEES: :29.50
CITY OF
YELM
P.O. Box 479
Yelm, WA 98597
360-458-8403
RECEIVED
""••TFIEDITY NINE DOLLARS & 50 CENTS
RECEIVED FROM
SUBSET SIR I1~C DATE REC. NO.
5210 LACEY BLVD 3E 05/04/06 41859
LACEY ifA 98503
BUDGETARY
RECEIPT No. 418 5 9
AMOUNT REF. NO.
29.50 CHECK 25795
H-05-0553-YL
CITY OF YELM ~ C'
COMMERCIAL BUILDING PERMIT APPLICATION FORM ~-4`~ ~/G
' / 1 /~.
Project Address: ~`, T ,~7-~-c `~i~L~(~L~ ~~Parcel #: c~ yy,~?/ >GG~ /L;~ n 3~p0~,
Zoning; ~- ~ i ~ - Z Current Use: Proposed Use:
^ New Construction ^ Re-Model / Re-Roof /Tenant Improvement
^ Plumbing ~' Mechanical ^ Fire Prevent/Suppress/Alarm ^ Other
Project Description/Scope of Work: 5 /~~/ ~~~ . ~~vr ~~u.2~o .~ ;
Project Value: ~ /~~'lJ~~ , D G
Building Area (sq. ft) Parking Garage 1't Floor 2n0 Floor 3"° Floor
Building Height
Are there any environmentally sensitive areas located on the parcel? ~ (C% If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER/T NANT NAME: i
ADDRESS /~ ~/ ~ ~-~.,~, i!_e ~~ ~ ~' EMAIL ~- : vi l'r
CITY_~~~~ STATE~~ZIP ~ ~ - TELEPHONE
ARCHITECT/ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
PLUMBING
CITY
CITY
Copy of City Mitigation documentation (TFC).
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.
.L ~ - 3 -~%
Applicant's Signatu Date
Owner /Contractor Owner's Agent /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 period of
180 days
R:\Forms & Proccdures\Building Permits\CommBldgPermitApp.doc Page 2 of 4
--_ -
DEI'.ARTMENT U}~ LAROR AND f1~UUSTRIES
'I
REGISTERED AS PROVIDED BY LAW AS
~ CONST CONT GENERAL
REGIST. # EXP. DATE II
CCO1 SUNSEA*220CM 02/03/2008 ~~
EFFECTIVE DATE 02/14/1978
SUNSET AIR INC
5210 LACEY BLVD SE
LACEY WA 98503
~'
rt; ~~~-,~;,., ~ut~ ~ n~~,~,
--- --
DcCic'h And llispla~ ('i~rtit'ie~tc
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL Pleatie Remove
REGIST. # EXP. DATE And Si~Tn
CCO1 SUNSEA*220CM 02/03/2008 Identification
EFFECTIVE DATE 02/14/1978
Card Before
SUNSET AIR INC Placing In
5210 LACEY BLVD SE Billfold
LACEY WA 98503
1~ ued b) DEP.~hT~v1F_'N~" (ll- LP.BOR r~NIJ If`+171r5TK1ES
vtgr.' CITI( OF l~ELI~
~~~~
CLERK -TREASURER'S OFFICE
~U~I1~~~S ~~C~~~
IJUT VALID UI~JTIL FEE IS PAID
UFTSCH, PFTFR ,
IS HEREi'.Y . IC:~IJSEG TG OPERATE
SI1N~~FT AIR , I NC .
511 LACFY Ff VD ~F
LAc'FY, VJA ~f?F,Of3
AT 7 ~11T CiF TOWN
This License must be posted In a conspicuous place at the business Iocatlon
~iF-~A175~i .Ol