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20050449 Permit Pkg 012406pF THEP~ City of Yelm .a~ ~~ Community Development Department a Building Division Phone: (360)458-8407 YELM Fax: (360) 458-3144 Applicant: Name: Washington Energy Service Address: 2800 Thorndyke Ave. W City: Seattle Property Information: Site Address: 410 West Rd SE Assessor Parcel No. 64303601503 Subdivision Contractor Information: Name: Washington Energy Service Contact: Thornquist, Linda Address: 2800 Thorndyke Ave. W City: Seattle Contractor License No: WASHIES97106 Expires: 04/02/0592 Project Information: Project: Simmons Description of Work: Gas Water Heater Permit rvo: PL-05-0449-YL Issue Date: 01124/2006 (Work must be started within 180 days) Receipt No: 40140 Phone: 206.282.4700 State: WA Zip 98199 Lot; Phone: 206.282.4700 State: WA Zip: 98199 Business License: 3050.1 Sq. Ft. perfloor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0 Heat Type (Electric, Gas, Other): OTHER Fees: Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc Plumbing Permit 27.00 20.00 7.00 7.0000 1 0000 Fixturev TOTAL FEES: $27.00 Appttcant;-s Artaaavitt: I certify that I have read and examined the information contained within the application and know the same OFFICIAL USE ONLY 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 State of Washington. ~, Final Insp~ctien~y( Signature Date Firm City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Applicant: Permit rvo: PL-05-0449-YL Issue Date: 01!24/2006 (Work must be started within 180 days} Receipt No: 40140 Name: Washington Energy Service Phone: 206.282.4700 Address: 2800 Thorndyke Ave. W City: Seattle State: WA Zip 98199 Property Information: Site Address: 410 West Rd SE Assessor Parcel No. 64303601503 Subdivision: Lot: Contractor Information: Name. Washington Energy Service Contact: Thornquist, Linda Phone: 206.282.4700 Address: 2800 Thorndyke Ave. W City: Seattle State: WA Zip: 98199 Contractor License No WASHIES97106 Expires: 04/02/0592 Business License: 3050.1 Project Inforration: Project: Simmons Description of Work: Gas Water Heater Sq. Ft. perfloor: (1st) 0 (2nd) 0 Heat Type (Electric, Gas, Other): OTHER t I'~ `t I 0 ~' Fees: ~ ~~ C~ ~:-- cam, ,• ~,~,~, Item Item Fee Basf ``~ --- ------------- --------- ---- ~ ~, ~ ~ ~.. ,. ~~ C' ~-- l .,~ ~ ~ c Plumbing Permit 27.00 TOTAL FEES: 527.00 tr Lam; ,1~~~.'(7 Cam. \~~~~ ~-t~> l I Applicant's Affadavit I certify that I have read and examined the information cc to be true and correct. I also certify that the proposed str Yelm regulations including those governing zoning and la easements and restrictions of record. If applying as a co registered in the State of Washington. Firm CITY OF YELM P.O. Box 479 Yelm, WA 98597 360-458-8403 RECEIVED ****TWENTY SEVEN DOLLARS & 00 CENTS RECEIVED FROM DATE REC. NO. WASHINTON ENERGY SERVICES CO 01/24/06 40140 THE PERMIT GROUP BUDGETARY 2800 THORNDYKE AVE W SEATTLE WA 98199 RECEIPT No. 4 014 0 AMOUNT REF.NO. 27.00 CHECK 5467 PLUM PERMIT WASHINGTON ENERGY SERVICES COMPANY THE PERMIT GROUP 2800 THORNDYKE AVE. W. SEATTLE. WA 98199 PH. 206-282-4700 ' PAY TO THE (` ~ .. f .y~ O-~ ORDER OF ~ U U 5467 ~~j Qi/ ~/ 98.882/1201 DATE ` L G 111 ~J ~~ ~ F o 0 1V D A T I O N NOT VALID OVER 52500 . .~ Pn.~2s-es,-sooo 1110 112th Avs NE Sts. 100 B.II.VU.. WA 98004 005467 . L 25 L086 25 . LO L00666 JAN-18-2006 01:15 Yelm CDD 360 468 3144 P.02 Permit Fees Schedule City of Yeim Comtnwuty DevelOp1118!f1t Dapa~imMtt Pemtit tJo: Pl.-05.0*t~-YL Building Division PA i D Phone: (as0) 45Tf•8407 ,IAN 2 4 711116 Fax: (380) 468.3144 ciN of YEt_nn s.~• Peons: ws.za2~c7oo None: Waahingbon Address: 2800 Thomdyke Ave. W ~. ~~ Sta4s: WA ~D 9819! ~.'~' i project: Simmons pescr~don of WoAc: Gas W~•~ ~ sn• Address: 410 wsat Rd sE Assessor Paroel No. 64303807',0s ~ ~-~~ ~~"''~~''~~'++..~":'. ~ .. s ~ "• cc ~ I:om Fse , .Bass Amt Unit Fee ~ . Unit Rave Nv. Unlf9 Unp Desc A t Item - Plumbirg Psftrllt 082 OOt-322-10-00 27.00 20.00 7.00 T.00~ 1.0000 Fhdcros 1'iDTAL FEES: ~•~ '~~e 231 ~(.~a sue- ~~~ i ~` ~~ ~~if~l~ot \ Z ~ ~'~'1av~ ~ y l~ e -~-L cx~ ~~ ~ ~~~ , ~~~~~v T/)TA7 n ~~