20050774 Permit Pkg 110606~OF T~A~ City of Yelm
07
Applicant:
Name: Fast Water Heater
Address: 12601 132nd Ave NE City: Kirkland
Property Information:
Site Address: 16123 Prairie Creek Loop
Assessor Parcel No. 69240005100 Subdivision:
Community Development Department
Building Division
Phone: (360) 458-84
EL Fax: (360) 458-3144
Contractor Information:
Name: Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: Davis H2O Tank
Description of Work: Replace gas hot water tank
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other):
Permit No: PL-05-0774-YL
Issue Date: 11/06/2006
(Work must be started within 180 days)
Receipt No: 44664
Phone: 425.814.3124
State: WA Zip 98034
Lot:
Phone:
State: Zip:
Business License:
Garage 0 Basement 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Plumbing Permit 27.00 _ 20.00 7.00 7.0000 1.0000 Fixture
TOTAL FEES: E27.00
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 restrictions of record. If applying as a contractor, I futher certify that I am currently
registered in the State of Washington.
Signature E~L~G `~G/ Date ~~/ ( ~f/~~
Firm 'YLG~-~K.l~'r ~~ S~G~ ~''f
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: Fast Water Heater
Address: 12601 132nd Ave NE
Property Information:
Site Address: 16123 Prairie Creek Loop
Assessor Parcel No. 69240005100
Contractor Information:
Name:
Address:
Contractor License No:
City: Kirkland
Subdivision:
Contact:
City:
Expires:
Project Information:
Project: Davis H2O Tank
Description of Work: Replace gas hot water tank
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd)
Heat Type (Electric, Gas, Other):
Fees:
Item Item Fee Base Amt
Plumbing Permit 27.00 20.00
TOTAL FEES: 527.00
Applicant's Affadavit:
Uni~
Permit No: PL-05-0774-YL
Issue Date: 11/0612006
(Work must be started within 180 days)
Receipt No: 44664
Phone: 425.814.3124
State: WA Zip 98034
Lot:
,.. -. ~1 ~ wY`- .
lXl~
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OFFICIAL USE ONLY
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 * 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:
Date:
Signature Date
--
I
--- By.
Firm
CITY OF
YELM
P.O. Box 479
Yelm, WA 98597
360-458-8403
RECEIVED ****TWENTY SEVEN DOLLARS & 00 CENTS
RECEIVED FROM DATE REC. NO.
FAST WATER HEATER 11/06/06 44664
12601 132ND AVE NE
KIRKLAND. WA 98034 BUDGETARY
PL-05-0774-YL
SITE: 16123 PRAIRIE CRK LP
RECEIPT No. 4 4 6 6 4
AMOUNT REF. NO.
27.00 CHECK 2218
PFRMTT 77 AA
~~~~
City of Yelm - ~ »~~~~,;-
Community Development Department
Building Division --~.~ ~F YE~
Phone: (360)458-8407
Fax: (360)458-3144
Applicant:
Name. Fast Water Heater
Address: 12601 132nd Ave NE
Project Information:
Project: Davis H2O Tank
Description of Work: Replace gas hot water tank
Site Address 16123 Prairie Creek Loop
City Kirkland
Permit Fees Schedule
Permit No. PL-05-0774-YL
Phone: 425.814.3124
State: WA Zip 98034
Assessor Parcel No. 69240005100
Fees:
Item Acct Code
Plumbing Permit 032 001-322-10-00
TOTAL FEES:
Item Fee
----------- Base Amt
----------- Unit Fee
-------- Unit Rate No. Units Unit Desc
27 00
20 00 ---
7,00 -----------
7.0000 ---------
1.0000 -------------
Fixture
527.00
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
16123 PRAIRIE CREEK LOC Parcel #: 69240005100
Lot #: Zoning;
~~ New Construction ^ Re-Model / Re-Roof /Addition r' Home Occupation Sign
DQ Plumbing Il Mechanical ^ Mobile /Manufactured Home Placement ^ Other
Project Description/Scope of Work: Remove/Replace Gas Water
Project Value:449.00
Building Area (sq. ft) 1 g` Floor 2"d Floor Garage Deck
Basement Carport Patio
# Bedrooms^ # Bathrooms- Heating: GAS/OTHER or ELECTRIC (Circle One}
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
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.
"~ G~ ~u1 'Gf ~ 11/2/06
Applicant's Signature Date
Owner /Contractor !Owner's Agent !Contractor's Agent (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
'Y
~~~ ~~~~
6~~ o
105 YeGn Auertue West (360) 458-3835
PO Box 479 (360) 458-3144 FAX
Yelnt, WA 98597 www.ci.yelnt..wa.us
Copy of mitigation agreement with Yelm Community Schools, if applicable.