20050758 Permit Pkg 101806City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: MCS Inc
Address: 4624 16th Street E., Ste. A-5 City, Fife
Property Information:
Site Address: 16533 SR 507
Assessor Parcel No. 64303200704 Subdivision
con><raccor mrormation:
Name: Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: Del's Furnace
Description of Work: Replace gas furnace with gas unit heater
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other): OTHER
Permit No: M-05-0758-YL
Issue Date: 10/18/2006
(Work must be started within 180 days)
Receipt No: 44177
Phone: 253.926.9777
State: WA Zip 98424
Lot:
Phone:
State: Zip:
Business License:
Garage 0 Basement 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Mechanical Permit 33.25 0.00 0.00 0.0000 0.0000
TOTAL FEES: 533.25
Applicant's 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 restri~s of-recer~lf applying as a contractor, I futher certify that I am currently
Firm
Date
PAID
City of Yelm Permit Fees Schedule
Community Development Department OCT ~ A ~~n( Pemtit No: M-0S-0758-YL
Building Division CITY OF YELM
Photo: (360) 458-8407
Fax: (380)458-3144
Appllcant•
Name: MCS Inc. Phone: 253.928.9777
Address: 4624 18th Street E., Ste. A-5 City: Fife State: WA Zip 98424
Project Information:
Project: Dsl's Furnace
Description of Work: Replace gas furnace with has unit heater
Site Address: 18533 SR 507 Assessor Parcel No.
Fees:
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Mechanical Permit 032 001-322-10-00 33.25 0.00 0.00 0.0000 0.0000
TOTAL FEES: :33.25
CITY OF
YELM
P.O. Box 479
Yelm, WA 98597
360-458-8403
RECEIVED ,~+-"THIRTY THREE DOLLARS & 25 CENTS
RECEIVED FROM DATE REC. NO.
NC3 INC 10/18/06 44177
4624 16TH ST E #A-5 BUDGETARY
fIFE. wA 98424
H-05-0758-YL
RECEIPT No. 4 417 7
AMOUNT REF. NO.
33.25 CHECK 2027
MECH PRHT
~~) ~~
~ i ~/~~~' r
CITY OF YELM ~ i~) /
_ COMMERCIAL BUILDING PERMIT APPLICATION FORM ~~ 'Q~
Project Address ~~~ :.r..J ~ t ~ ~ Par el #: ~ ~ ~ 00 ~~
~~ ~~ l /`
Zoning; Current tJ?;"e~ ' ~~ C~~-"`Prdpo ed Use: ~f' F
~o~' O
~ New Construction i i Re-Model / Re-Roof /Tenant Improvement
U Plumbing ~ Mechanical ~ ~ Fire PrevenUSuppress/Alarm . ~ Other
Project Description/Scope of Work: ~~ ~= _ -~~-~ j- ~,~ (~~,~~_, (~ / (-~-~~
Project Valu~ ~~ D~, (~(> t-T ~G~~-
2, ~' ~
st nd rd
Building Area (sq. ft) Parking Garage 1 Floor~~2 Floor 3 Floor ~ /~
Building Height ~~ Z ~~ ~ ~
Are there any environmentally sensitive areas located on the parcel? If es, a ~
Y
completed environmental checklist must accompany permit application.
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
A phcant' ture ~ Date
Owner / ontracto 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
I05 Yelm Avenue West (360) d58-3835
PO Box 479 (360) 458-3J4~f FAX
Yelm, WA 98597 wurw.ei.yelm.ura.ua
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.