07-0093 Permit Pkg 030907~pF THFA City of Yelm
Community Develo
Building Division
Phone: (360) 458-8407
I. Fax: (360) 458-3144
Applicant:
Name: Hassan Corp
Address: 11908 Pacific Ave.
Property Information:
Site Address: 16507 SR 507 SE
Assessor Parcel No. 64303200701
Contractor Information:
Name: Alaska Marine Refrigeration
Address: 9991 SE Cottonwood Dr.
Contractor License No: ALASKMR968KR
Project Information:
Project: AMlPM SR 507
Description of Work: New back flow device
pment Department
City: Tacoma
Subdivision:
Contact:
City: Port Orchard
Expires: 05119!08140
Sq. Ft. perfloor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other)
Permit No: PL-07-0093-YL
Issue Date: Ne~ssued.-~
3~1~~~
(Work must be started within 180 days)
Receipt No: 47647
Phone: 36058-4477
State: WA Zip 98444
Lot:
Phone: 360-871 X414
State: WA Zip: 98366
Business License:
Garage 0 Basement 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Plumbing Permit 25.00 20.00 ~ 0.00 7.0000 0.0000 Fixture v
TOTAL FEES: 325.00
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 they state of Wa~hingto{i. ~~
aignarure ~~/ ~,~/ ~.(_.~ v vU Date
Firm ~~~ ~ ~/~.
~~
k Sets of Prints:
inallnspection:
Date:
By:
~• „ h
',';~~~""°" CITY OF
r - = YELM
`~'~~" -
v,r~ ~~~qf;~;u; RECEIPT No. ~ ~
YEt.M ~;(I-~jSP,'t;t19
;I `_ ~ I' ~Cf ~ ,,. * * TWENTY FIVE DOLLARS & 00 CENTS
ir~~.I~,i(;~ ;i;~~.~ Cn~IL HLC:f~,O A~~AUI!hdi ~iLFFdO.
ALASKA MARINE REFRIGERATION INC 03/09/07 47647 25.00 CHECK 11942
9991 SED COOTONWOOD DR
PORT ORCHARD WA 98366 BUDGETARY
360-871-4414
1iICHELLE _ _
E'LUMBING PERMIT 25.00 PL-07-0993-YL
AM Ptd SR 507
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: ~ ~" ~~ ~ .SI~ ~~ 1 ~~ Parcel #: ~~ 4 3C ~~L ZC ~
Zoning; ~ 2 Current Use: ~~ ~+~ ~)iz~ Proposed Use: ,~~.~11'h -
~7 New Construction ^ Re-Model / Re-Roof /Tenant Improvement
Plumbing 0 Mechanical f_; Fire PrevenUSuppress/Alarm ^ Other
Project Description/Scope of Work: ~'~ ~1~ l ? ~CL 2.17
Project Value: ~'' l ~-\ I ~ ~ ~~' ~ ~ I --
Building Area (sq. ft) Parking Garage 1" Floor 2nd Floor Std Floor
Building Height
I
Are there any environmentally sensitive areas located on the parcel? / ~ ~' If yes, a
completed environmental checklist must accompany permit application.
Copy of City Mitigation documentation (1'FC).
l hereby certify that the above Information is con~ect and that the construction on, and the occupancy and the use of the
above described property will be in accoMance with the laws, rules and regulations of the State of Washington and the
City of Yelm. '
~ II-.~
X.~
Applicant's Signature Date
Owner /Contractor / Owne 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
105 Yelm Avenue Weat (360) 458-3835
PO Box 479 (360) 458-3144 FAX
Yeim, WA 98597 u,wro.ci.yelm.u!a.us