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07-0184 Permit Pkg 050207~pF Tip City of Yelm Community Development Department d Building Division Phone: (360) 458-8407 ELM Fax: (360) 458-3144 Applicant: Name: NW Refrigeration Address: 6111 Esther Ave. SW City: Tumwater Property Information: Site Address: 15762 104th Ave. SE Assessor Parcel No. 85840003200 Subdivision: NIA Contractor Information: Name: Applicant Contact: Address: City: Contractor License No: Expires: Project Information: Project: Lulich A/C Description of Work: A/C Unit Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0 Heat Type (Electric, Gas, Other): Permit No: M-07-0184-YL Issue Date: Not Issued (Work must be started within 180 days) Receipt No: 48400 Phone: 360-754-4030 State: WA Zip 98501 Lot: Phone: State: Zip: Business License: Garage 0 Basement 0 Fees: Item Item Fee Base Amt Unit Fee Unit Rate Mechanical Permit 29.50 0.00 0.00 0.0000 TOTAL FEES: $29.50 Applicant's Affadavit: No. Units Unit Desc 0.0000 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 / [__ /~~ /~ 1 Date ~~- ~ - (j "~ Firm % ~(,~. (/C f' 77 r w 'I r,.~ti.. at CITY OF YELM P.O. Box 479 Yelm, WA 98597 360-458-3244 RECEIVED TWENTY NINE DOLLARS & 50 CENTS RECEIVED FROM DATE REC. NO. NORTHWEST REFRIGERATION 05/02/07 48400 5201 CAPITOL BLVD TUMWATER WA 98501 BUDGETARY RECEIPT No. 4 8 4 0 0 AMOUNT REF. NO. 29.50 CHECK 21094 City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360)458-3144 Applicant: Name: NW Refrigeration Address: 6111 Esther Ave. SW Project Information: Project Lulich A/C Description of Work: A/C Unit Site Address: 15702 104th Ave. SE City: Tumwater Permit Fees Schedule Permit No: M-07-0184-YL Phone: 360-754-4030 State: WA Zip 98501 Assessor Parcel No. 85840003200 Fees: Item Acct Code Mechanical Permit 032 001-322-10-00 TOTAL FEES: Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc 29.50 0.00 0.00 0.0000 0.0000 $29.50 ~~4 ~t ~~ . ~ (~ .-, ~ , c ` % / r~~ . . ~ ~ /~ _~ , c L ~,}- { y~L ~~ >a t ~ 1 ~ ~ ~~J 1 ~. h, ~ ~'I ~ ~ _. ~ ~ . CITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM Project Address: ~ 5-10 X `~y~~ ~~ S~ Parcel #: ~ 5 ~ ~ 0 003 ~O n Subdivision: Lot #: Zoning; New Construction i Re-Model / Re-Roof /Addition i Home Occupation Sign Plumbing ~ Mechanical ~ Mobile /Manufactured Home Placement _i Other Project Description/Scope of Work:~~pS ~ ~~~ ~ ~ C t,~s .~ Building Area (sq. ft) 1~' 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. 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 above described property will be in accordance with the laws, rules and regulations of the State of Washington and the City of Yelm. - ~ ' `- ~~ A icant's ignature Date er /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 IU5 Yelm Auere-ie West (360) 458-3835 PO Box 479 (360) 458-3144 FAX Yelm, WA 98597 www.ci;yelm.wa.ua May-O1-07 12:36P I ~_ ~• of THE ~ ..,: ,~. ,Q.~.::--- --.!tr~~ Q~' \i~ --: Y lv LM CITY OF YELM PO BOX 479 Yelrn WA 98597 (360) 458-3244 APPLICATION FOR BUSINESS LICENSE OFFICIAL uSE ONLY Fee RCVd sY Comm Dev. Dept. 8tdp Dept, Insp. pale Lit. Np. Upon receipt of license application, the City of Yelm will conduct an inspection of the premises for building and fire code conformance. Upon approval from the Yelm Building Department of said premises, the City Clerk's Office will process a business license and billing for f35.00 and mail to applicant at address listed below. License fee is due tyro weeks after issue date of license. P.02 Application is hereby made for a Business License for the City of Yelm ~ ~EW BUSINESS ~ NAME CHANGE/MAILING ADDRESS CHANGE ONLY DATE ~~ - ~ - ~~ BUSINESS NAME ~ ~ ~~ NATURE OF BUSINESS ~~ ~.C_ Sc~~ ~, ~~~~ c e BUSINESS LOCATION ADDRESS ~0~ ~~ or ~yj 2 W~ _\ ~R1 ~~(;.~25 • `v~l MAILING ADDRESS S,~(~\ ~lao ~~ ~~ ~~~~ ~,~(~\ ~Uct~ ~~ec ~\~_•~{~ l ANTICIPATED OPENING DATE DAYS & HOURS OF OPERATION OWNER(S) Q Birthdate Sociall Security No. ~ 1 ` `a Address ,~~\~ ~.~S~~Q r ~Jrr S +~~U~~~ L,,j3~ [ p SU I City State Zip TELEPHONE~~-?i>1-9 /~~ ~loO•~.5~-~~~t1 (Business) (Home/Emergency) CONTRACTOR'S REGISTRATION NO. (If applipble) THURSTON CO. HEALTH APPROVAL NO. STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI) ~~_~3~ y~ CITY OF Yl'_L'1~J BUSINESS LICFN,Sf= APPLICATION (Ene.1We oYDtiO~) - rts/c:lmyfileslformalbuslic.ePP