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07-0202 Permit Pkg 053007~o,< T"FA City of Yelm ~`9 ~ Community Development Department /+ Building Division Phone: (360) 458-8407 LM Fax: (360) 458-3144 Applicant: Name: Beyer, Kyle Address: 16514 92nd Ave. SE City: Yelm Property Information: Site Address: 16514 92nd Ave. SE Assessor Parcel No. 63540004500 Subdivision: Contractor Information: Name: Applciant Contact: Address: City: Contractor License No: Expires: Project Information: Project: Beyer Heat Pump Description of Work: Heat Pump Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0 Heat Type (Electric, Gas, Other): OTHER Fe¢s: Item - -_-~-- Item Fee Base Amt Unit Fee Mechanical Permit 29.50 Y~0.00 0.00 TOTAL FEES: b29.50 Permit No: M-07-0202-YL Issue Date: 05/30/2007 (Work must be started within 180 days) Receipt No: 48876 Phone: 539-1828 State: WA Zip 98597 Lot: Phone: State: Zip; Business License: Garage 0 Basement 0 Unit Rate No. Units Unit Desc 0.0000 0.0000 Applicants Affadavit: I certify that I have read and examined the information contained within the application and know the same OFFICIAL USE ONLY -l, 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, # Sets of Prints: 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: Signature ~ ~~ ~ ~ Date: ~ !t-.l~_" -~ G~s~~ Date ~~ Firm ~ By: City of Yelm Community Development Department Building Division Phone: (360)458-8407 Fax: (380)458-3144 Applicant: Name: Beyer, Kyle Address: 16514 92nd Ave. SE Project Information: Project: Beyer Heat Pump Description of Work: Heat Pump Site Address: 16514 92nd Ave. SE Feea: Item Acct Code Mechanical Permit 032 001-322-10-00 TOTAL FEES: CITY OF YELM P.O. Box 479 Yelm, WA 98597 360-458-3244 RECEIVED RECEIPT No. 4 8 8 7 6 ****TWENTY NINE DOLLARS & 50 CENTS RECEIVED FROM DATE REC. NO. AMOUNT REF. NO. DANIELLE BEYER 06/07/07 48876 29.50 CHECK 1397 16514 92ND AVE SE YELM WA 98597 BUDGETARY City: Yelm Permit Fees Schedule Permit No: M-07-0202-YL Phone: 539-1828 State: WA Zip 98597 Assessor Parcel No. 83540004500 Item Fee Base Amt _ Unit Fee Unit Rate No. Units Unit Desc 29.50 0.00 0.00 0.0000 0.0000 _____ 529.50 M-07-0202-YL CITY OF YELM ~ C RESIDENTIAL BUILDING PERMIT APPLICATION FORM ~ 4 , ~~~ Project Address: 1 le7 14 9 Z~ ~ t\~,;= ~c Parcel #: __ ~ 3 5 ~~~~ ~~~, 5 UU , ` ~ ~ %' O ii? Subdivision:_Nl I , ~v;~,,,sr:. Lot#: ~~ Zoning; > New Construction ~ Re-Model / Re-Roof /Addition Home Occupation Sign ~ ~ ~ Plumbing G( Mechanical ~ Mobile /Manufactured Home Placement ! Other Project Description/Scope of Work: (,~~{ , ~ ~ ~,,`~ ' ~ bta n ~„ o Project Value: Building Area (sq. ft) 1~' Floor 2"~ Floor Garage Deck Basement Carport Patio # Bedrooms ~ # Bathrooms Heating:~GAS/OTFiER!or ELECTRIC (Circle One) Are there any environmentally sensitive areas located on the parcel? 1~; 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 YYashington and the City of Yelm. C~! .z,- ,~~~ ~ / ~" Applicant's Signatur °~I ~~ Da e Owner /Contractor / ner'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 Avenue Weat PO Box 479 (360) 458-3835 Yelm, WA 98597 (360) 458-3144 FAX urwm.ci.yelm.wa.us Copy of mitigation agreement with Yelm Community Schools, if applicable.