20050467 Permit Pkg 032806~~of Tip City of Yelm
Community Develo
4
Building Division
Phone: (360) 458-840
YEL Fax: (360) 458-3144
pment Department
7
Applicant:
Name: Miller, Don
Address: 203 Yelm Ave. WEst City: Yelm
Property Information:
Site Address: 203 Yelm Ave. West
Assessor Parcel No. 85800300100 Subdivision:
Contractor Information:
Name: G 8 G Heating Contact:
Address: 8140 Old Hwy 99 SE City: Olympia
Contractor License No: GGHEA•"162Q7 Expires: 1 111 6106 3 2 0
Project Information:
Project: Screaming Chicken
Description of Work: Add evaporative Cooler
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other):
Permit rvo: M-05-0467-YL
Issue Date: 03/28/2006
(Work must be started within 180 days)
Receipt No: 41254
Phone:
State: WA Zip 98597
Lot:
Phone: 360-943-0964
State: WA Zip: 98501
Business License:
Garage 0 Basement 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Mechanical Permil _ 29.50 ~~ 0.00 w0.00 0.0000 0.0000
TOTAL FEES: 529.50
Affadavit
I certify that I have read and examined the information contained within the application and know the same
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regulations including those governing zoning and land subdivision, and in addition, all covenants,
easements and restnctiQns of record. If ying as a contractor, I futher certify that I am currently
registered in the Sta Washington.
Signature Date ~~
Firm ~ ~.-. ff ~~/ ~~~
Final Inspection:
Date:
By:
CITY OF
YELM
P0. Scx 479
Yelm, WA 96597
360 458.8403
DECEIVED ****TWENTY NINE DOLLARS & 50 CENTS
__ ~~`~~C ~~O\~1 CAI ~ ~;~G NO
DON MILLER 03/28/06 41254
203 YELM AVE W
YELM. WA 98597 BUDGETARY
RECEIPT No. 412 5 4
a~nour~ ~ - - .._
40.00 CASH
10.50-CASH
29.50 TOTAL
DIANA
MECH PERMIT
City of Yelm Permit Fees Schedule
Community Development Department PAID Permit No: M-05-0467-YL
Building Division
Phone: (360) 458-8407 ~ Q ~ sC ~' ' n ~ ; `
Fax: (360) 458-3144 C~-~/ QF YELNf
Applicant:
Name: Miller, Don
Address: 203 Yelm Ave. WEst
City: Yelm
Phone:
State: WA Zip 98597
Project Information:
Project: Screaming Chicken
Description of Work: Add evaporative Cooler
Site Address: 203 Yelm Ave. West
Fees:
Item Acct Code
Mechanical Permit 032 001-322-10-00
TOTAL FEES:
Assessor Parcel No. 85800300100
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
29.50 0.00 0.00 0.0000 0.0000
529.50
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: ~d 3 T~1~~ ~-!/ Parcel #: ~~/~D~o~ ~~
Zoning; Current Use: Proposed Use:
U New Construction U Re-Model / Re-Roof /Tenant Improvement
U Plumbing 'Mechanical UQ Fire PrevenUSuppress/Alarm U Other ~ I
Project Description/Scope of Work: ~C{ ~~ ~~/¢/~Jk'~~~i/~ ~~~`'~~~ ~ ~~ ~` ~~`'"
Project Value:
Building Area (sq. ft) Parking Garage 1~ Floor idDy 2nd Floor 3rd Floor
Building Height i , ~ '
Are there any environmentally sensitive areas located on the parcel? __~~~ If yes, a
completed environmental checklist must accompany permit application.
~ARCHITECT/ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHUNt
GENERAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICALCONTRAC OR .t ~ 1-y~ TELEPH~NE _'.- ~ 36 6
ADDRESS 3iHD (`-/~~N~l `' S~ EMAIL L>' ~ ' i•4T (~ ~~ (, Cti:~
CITY `'! ~ u ~ STATE tv~ ZIP ~~ / FAX `jti3 0~~~2
CONT CT R'S LICENSE # ' =' (° / EXP DATE ~/-C.CITY LICENSE #
Copy of Clty Mkigation documentation (TFC).
1 hereby certHy 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 wkh the laws, rules and regulations of the State of Washington and the
City of Yelm.
Applicant' re Date
Owner / ontracto~ Owner's Agent I 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
105 Yelm AuenueWeBt (360) 458-3835
PO Bos 479 (360) 458-3144 FAX
Yelm, WA 95597 mu~w.ci.yelm.u~o.ue
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A business registered as a construction contractor with LFtI to perform construction work within the scope
of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment
of account and carry general liability insurance.
Information
License GGHEA""162Q7
Licensee Name G 8 G HEATING
Licensee Type CONSTRUCTION CONTRACTOR
UBI 600491732 V~ri~ Work~r~ Comp Premium
Status
Ind. Ins. Accou'dt 50355100
Business Type INDIVIDUAL
Address 1 5034 LEMON RD N E
Address 2
City OLYMPIA
County THURSTON
State WA
Zip 98506
Phone 3609430964
Status ACTIVE
Specialty 1 GENERAL
Specialty 2 UNUSED
Effective Date 11 /27/1984
Expiration Date 11/16/2006
Suspend Date
Separation Date
Parent Company
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License
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Business Owner Information
Name Role Effective Date Expiration Date
GEORGE, GARY J OWNER 01 /01 / 1980
Bond Information
Bond
Company Bond Account Effective Expiration Cancel Impaired Bond Received
Bond Name Number Date Date Date Date Amount Date
Until
#7 CBIC SA3280 11/16/2001 Cancelled $12,000.00 10/31/2001
#6 CBIC SA3280 11/16/1997 11/16/2001 $6,000.00
#5 CBIC SA3280 11/16/1996 11/16/1997 $6,000.00
DEVELOPERS
#4 INS CO 199628C 11/16/1995 11/16/1996 11/20/1996 $6,000.00
AETNA
CASUALTY &
#3 SURETY CO 8151007244726CA 11/16/1991 11/16/1995 $6,000.00
AMERICAN
STATES INS
#2 CO EX573688 11/16/1987 11/16/1991 $6,000.00
STATE FARM
FIRE I't
CASUALTY
#1 CO 986976753 11/16/1984 11/16/1988
Savings Information
No Matching Information
Information
Insurance Company
Name
Policy Number Effective
Date Expiration
Date Cancel
Date Impaired
Date
Amount R
AMERICAN
STATES INS
#24 CO 01CG33772730 05/28/2004 05/28/2006 $1,000,000.00 05
AMERICAN
STATES INS
#23 CO 01CG3377271 05/28/2003 05/28/2004 $1,000,000.00 06
ASSURANCE
CO OF Until
#22 AMERICA SCP35035428 05/28/2001 Cancelled 10
MARYLAND
CASUALTY Until
#21 INS CO SCP35033428 05/28/1999 Cancelled
MARYLAND Until
#20 CAS INS CO TBD 05/28/1999 Cancelled
VALLEY INS Until
#19 CO 4103CP002699 11/16/1998 Cancelled 06/27/1999
VALLEY INS
#18 CO 4103CP00269902 11/16/1997 11/16/1998
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VALLEY INS
#17 CO TBD 11/11/1996 11/11/1997
AMERICAN
#16 STATES 01CD85109902 11/16/1995 11/16/1996
FARMINGTON
#15 CAS CO 081MP0024538408TWF 11/16/1994 11/16/1995
FARMINGTON
#14 CAS CO 0023779165 11/16/1993 11/16/1994
#13 AETNA 22935882 11/16/1992 11/16/1993
#12 AETNA TBD 11/16/1991 11/16/1992
AMERICAN
#11 STATES 01CC5129363 11/16/1991 11/16/1992
AMERICAN
#10 STATES 01CC5129362 11/16/1990 11/16/1991
AMERICAN
STATES INS
#9 CO 010005129361 11/16/1989 11/16/1990
AMERICAN
#8 STATES 02CC1524542 11/16/1988 11/16/1989
AMERICAN
STATES INS
#7 CO 02CC15245410 11/16/1987 11/16/1988
STATE FARM
FIRE 8
CASUALTY Until
#6 CO 987489368 11/16/1987 Cancelled
STATE FARM
FIRE Ft
CASUALTY Until
#5 CO 987356431 11/16/1986 Cancelled
STATE FARM
FIRE 13
CASUALTY Until
#4 CO 987193749 11/16/1985 Cancelled
STATE FARM
FIRE 8 CAS
#3 CO 987036751 02/22/1985 02/22/1986
AMERICAN
STATES INS
#2 CO AP74394 11/16/1984 11/16/1985
STATE FARM
FIRE tt
CASUALTY
#1 CO 986976777 11/27/1984 11/16/1985
Summons /Complaints Information
No Matching Information
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