20050796 Permit Pkg 122206~~~~~ 1}'~=N,~~ City of Yelm
Property Information:
Site Address: 16338 Cascadian Ave. SE
~ Community Development Department
a
Building Division
Phone: (360)458-8407
YELM Fax: (360)458-3144
Applicant:
Name: Pacific Air
Address: 2727 Martin Way City: Olympia
Assessor Parcel No. 84070000200 Subdivision
contractor Inrormanon:
Name: Applicant Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: Daniel Residence
Description of Work: Gas Stove Installation
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other):
Permit No: M-05-0796-YL
Issue Date: 12/22/2006
(Work must be started within 180 days)
Receipt No: 45068
Phone: 360-357-4328
State: WA Zip 98506
Lot:
Phone:
State: Zip:
Business License:
Garage 0 Basement 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate
Mechanical Permit 25 00 0.00 0.00 0.0000
TOTAL FEES: $25.00
No. Units Unit Desc
0.0000
Applicant's Affadavit:
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,
easement re§ftictions of record. If applying as a contractor, I futher certify that I am currently ' ~
registered 'n the State 6fWa~hington. Final Inspe io
r ~ ~ D /!',
Signature .,,,.' t ~ ~~-,---- Date
.. /.1- ~ ;.2 - ~ ~
Firm / j~~c~ ~i c ~~l.2 / . -_ By:
/ ~ iv ~
CITY OF
YELM
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360-a58-F+aO.i
RECEIVED , , , ~ . T ~ ~~~ r;r,; ~ - '
Ti'iFN ,'i FT ~t: : i~Lr,;',
RECEIVED FRUM
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RECEIPT No. 4 5 ~ 6 8
ENT:.
DATE REC, NO- AMC)UNT
REF Nb.
J
~~oF,rHEp~~ City of Yelm
9~ Community Development Department
n, m
Building Division
Phone: (360) 458-8407
YELM Fax: (360) 458-3144
Applicant:
Name: Pacific Afr
Address: 2727 Martin Way City: G
Project Information:
Project: Daniel Residence
Description of Work: Gas Stove Installation
Site Address: 16338 Cascadian Ave. SE
PAI C~ Permit Fees Schedule
Permit No: M-05-0796-YL
DEC: 2 t ~iii~i,
CITY OF YELM
/~ ~~
Phone: 360-357-4328
pia State; WA Zip 98506
Assessor Parcel No 84070000200
Fees:
Item Acct Code
Mechanical Permit 032 001-322-10-00
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
25.00 0.00 0.00 0.0000 0.0000
TOTAL FEES: $25.00
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address:_1~ - h .~~' ~%~:;~ i~~l ~~~iv Parcel #: ~ y~ ~G ~'~ ~ :~ ~~
c ~= ~ ;~
Subdivision: Lot #: Zoning;
u New Construction ~_t Re-Model / Re-Roof /Addition u Home Occupation Sign
u Plumbing u Mechanical L.1 Mobile /Manufactured Home Placement u Other
of Work: ~~ ~r~v~ _Lt+rJ~~'7~c~-~ar-,..~.~/
~~
Building Area (sq. ft) 1" Floor 2n0 Floor Garage Deck
Basement Carport Patio
# Bedrooms- # Bathrooms- Heatin . GAS/,bTHER or ELECTRIC (Circle One)
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 TELEPHONE
GENERAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
~ ~~ ~ `~7
Copy of mitigation agreement with Yelm Community Schools, if applicable.
I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the
abov scribed property will be in accordance with tha laws, rules and regulations of the State of Washington and the
City f Yelm.,
a !~
Applicant's Signature Date
O~lner /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
105 Yelm Auenue Weat (360) 458-3835
PO Bor 479 (360) 458-3144 FAX
Yelm, WA 98597 wwm.ci.yelm.rua.ua
Jan 09 07 08:59a Pacific Air, Inc
360-956-9859 p.1
Pci~ilc..~i
~.
FAX TRANSMITTAL
To: Gary COMP: City of Yelm
PHONE: 458-8403 FAX: 458-3144
FROM: Jirn Brewer
PHONE: (360) 357-4328 FAx: (360) 956-9859
RE: CCST Certification
DATE. January 9, 2007 PAGES: 2 (includes cover)
^ URGENT ^ FOR REVIEW ^ PLEASE COMMENT ^ PLEASE REPLY ^ PLEASE RECYCLE
Gary,
Following please find a copy of the Gastite certification card for Phillip Brown, our employee who gas
piped the Daniel's residence at 16338 Cascadian Ave SE.
P give me a call if you have any further questions.
m Brewer
Comfort Consultant
Pacific Air, Inc.
2727 fti1ARTIN WAY E • OLYb1PIA, WA 98506 • PHONE' (360) 357-4328 • FAX: (360) 956-9859
Jan 09 07 08:59a Pacific Air, Inc 360-956-9859 p.2
Gast~fe~
system
TM hlowwg oar7on nos s~c*stti,nr n-nnbied Mc Gawte
- Co~li7~non Train'n9 r'iogr+m any tt hoiepr'pco~nitodas a
Qualified Gastite Installer
- PhII'ip 8ro~m
Name - -- Rick Thompson
' -. Paofic Air Instructor
oeaarza:2 '_ ' -
Ccmpany Dale 5 .•'.;._..
01f1975a3
Certificate No. Sbi66
.,.roe~a w purrs~ase ano ~su~ Gas~~e fM~clpk Gas Plpiny ~
Perfection PerTnasert - _ - - ^ _
Underground Gas Piping System
Toe fo!-own4 Dasa+r 6os suecas~ulfy crnvolrfrd Nu Prr,4cprn Penrrasert
frgihing program orrd tt Firr[by raaoni:rd os a
C~etn[i~ied lnstaller
lnstalfer.
Instructor: a -