07-0287 Permit Pkg 080807~oF TEA City of Yelm
or9 ~ Community Development Department
~ KKK
Building Division
Phone: (360)458-8407
E Fax: (360)458-3144
Applicant:
Name: Washington Energy Service
Address: 2800 Thorndyke Ave. W City, Seattle
Property Information:
Site Address: 15142 105th Ave. SE
Assessor Parcel No. 65080005500 Subdivision:
Contractor Information:
Name: Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: Copenhaver Heat Pump
Description of Work: Replace 3 ton heat pump
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other):
Fees:
Item Item Fee Base Amt Unit Fee
Mechanical Permit _ 29.50 0 00 Y 0.00
TOTAL FEES: =29.50
Applicant's Affadavit:
~ ~ z~.
~~
Permit No: M-07-0287-YL
Issue Date: 08/08/2007
(Work must be started within 180 days)
Receipt No: 49910
Phone: 206.282.4700
State: WA Zip 98199
Lot:
Phone:
State: Zip:
Business License:
Garage 0 Basement 0
Unit Rate No. Units Unit Desc
0.0000 0.0000
OFFICIAL USE ONLY
1 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 th to of Washin ton. Final Inspection:
Signature /~ ~J Date Date:
Firm By.
City of Yelm Permit Fees Schedule
Community Development Department ~~.~ 6 ~ Permit No: M-07-0287-YL
Building Division ~)j~i
Phone: (360) 458-8407 R ?_0~)
Fax: (360) 458-3144 C I TY OF Y,F~M
Applicant:
Name: Washington Energy Service
Address: 2800 Thorndyke Ave. W
Project Information:
Project: Copenhaver Heat Pump
Description of Work: Replace 3 ton heat pump
Site Address: 15142 105th Ave. SE
Phone: 206.282.4700
City: Seattle State: WA Zip 98199
Assessor Parcel No. 65080005500
Fees:
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
--------------------------
Mechanical Permit 032 001-322-10-00 29.50 0.00 0.00 0.0000 0.0000
TOTAL FEES: $29.50
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: ~ ~ ~ ~~- ~ V ~ ~~` ~arcel #: ~ S ~ g ~~~ ~d
Subdivision: Lot #: Zoning;
New Construction •~~~ / Re-Roof /Addition Home Occupation Sign
Plumbing IYl~echanical Mobile /Manufactured Home Placement Other
Project Description/Scope of Work: ~~ C~ 3 t D 1~i ~-~-~ r~N ( -~-~~ P~aA, P
Building Area (sq. ft) 151 Floor 2nd 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? N U If yes, a
completed environmental checklist must accompany permit application.
ARCHITECT/ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
LICENSE
CITY
Copy of mitigation agreement with Yelm Community Schools, if applicable.
information is correct and that the construction on, and the occupancy and the use of the
be in accordance with the laws, rules and regulations of the State of Washington and the
/ Contractor I
~D 2~T.
Date
circle one.)
All permits are non-transferable and will expire 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 West
PO Box 47.9
Yebn, WA 98597
(360) 458-31335
(360) 458-3144 FAX
www.ci.~~elm.u~a.us
07/03/2007 TvE 11:38 Frx 206 378 6600 ~nehington energy 6vice.
®002/002
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Property Owners Name: ~o_ __ ~ A55C55or'S parcel
Site Address: ~S_/k~ 1 s1.t. /eve ~~. ~/~ elw-
Site Plan
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