20050310 Permit Pkg 092705~~p4 THFP City of Yelm
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Property Information:
Site Address: 15738 91st Way SE
Assessor Parcel No. 43380000300 Subdivision:
ommunity Development Department
4
Building Division
Phone: (360) 458-8407
LM Fax: (360) 458-3144
Applicant:
Name: All Seasons Inc.
Address: 5001 N 28th St City: Tacoma
Contractor Information:
Name: Applicant Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: Burkhardt A/C
Description of Work: 2.5 Ton A/C
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other):
Permit No: M-05-0310-YL
Issue Date: 09/27/2005
(Work must be started within 180 days)
Receipt No: 38351
Phone: 253-879-9143
State: WA Zip 98407
Lot:
Phone:
State: Zip:
Business License:
Garage 0 Basement 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate
Mechanical Permit 33.25 _ 0.00 0.00 0.0000
TOTAL FEES: $33.25
No. Units Unit Desc
0.0000
~e.~~- m~SfA.~e. c.~,~~ A/i .~s~,J fry 3~"/vim
Applicant's Affadavit:
OFFICIAL USE
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,
easements and restrictions of record. If applying as a contractor, I futher certify that I am currently
registered in the Styes of Washington. ~ Final Inspection:
Signature ~/~ Date 0 1 -~-(~S Date
Firm ~ S' ~IIJr. By~ -
~~
~t utr nN „ CITY OF
.~m YELM
~~• ~ F?0. Bnx d79
YFIm, WA 98591
YELM 360.458-8463
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RECEIPT No. 3 $ 3 51
flEGCIVCD fHOM DATE REC. N0. AMOUNT RED PJO.
CITY OF YELM
RE5IDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 15-38 9 I~ Wy 5E Parcel #: 4 3380000 3co
Subdivision: Lot H: Zoning;
G New Construction r ^ Re-Model / Re-Roof / Addition CJ Home Occupation Sign
Basement Carport Patio
# Bedrooms # Bathrooms, Heating; GAS/OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? No li yes, a
completed environmental checklist must accompany permit application.
^ Plumbing Mechanical ^ Mobile /Manufactured Home Placement ^ Other
Project Description/Scope of Work: 11,-1STAlL 211i'fDy,~ 105E~~- ~°__ C'.pr~DlTlp-,x~.
Project Value: 3 2oc~ • °°
Building Area (sq. ft) 1't Floor 2"`' Floor Garage Deck
BUILOING~0INNEA,NAME: KOBE.2T F3~~t~AQ-DT -
ADDRESS IS~-38 ~I wA~ SE.
CITY ~-I~-~U STATE~_ZIP 9a~~' TELEPHONE 3tob -4a~• 2.5-5
QRCHITE~T/,ENGINE LIC E #
ADDRESS
CITY STAT ZIP TELEPHO
GENERAL'CONTAACTOR TELEPHONE
ADDRESS
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE ff EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable.
I hereby certiry that ll~e abv~e information is correct and that the construction on, and the occupancy and the u3e
of the above described property will be in accordance wish the laws, rules and regulations of the Stat® of
Washington he City of Yelm.
Applic s Si na r Date
Owner / Contracto wner'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
160 days
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