20050778 Permit Pkg 112106~oF THFP~~ City of Yelm
~!~ Community Development Department
4 en
Building Division
Phone: (360) 458-8407
YEL Fax: (360) 458-3144
Applicant:
Name: Bill's Towing
Address: 801 Yelm Ave W A-1 City: Yelm
Property Information:
Site Address: 801 Yelm Ave W - Al
Assessor Parcel No. Subdivision:
Contractor Information:
Name: Contact:
Address: City:
Contractor License No: Expires:
Permit No: M-05-0778-YL
Issue Date: 11/21/2006
(Work must be started within 180 days)
Receipt No: 9959
Phone: 360.458.5963
State: WA Zip 98597
Lot:
Project Information:
Project: Advantage Collission Gas Piping
Description of Work: Gas Piping from Bill's Towing to Advantage Collission for heat
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0
Heat Type (Electric, Gas, Other):
Phone:
State: Zip:
Business License:
Basement 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Building Permit -Other _ 25.00 0.00 0.00 0.0000 0.0000 $1,000`
TOTAL FEES: $25.00
Applicant's Affadavit:
OFFICIAL USE ONLY
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 State of Washington, Final Inspection:
Signatu / Date Date:
Firm By
~.r ~'Y OF YF'i,Ri
KEEP THIS COPY FOR YOUR RECORDS
5L250 02001 R®1FOIiMw
11/14/2006 09:16 360-458-4348 CITY OF YELM PAGE 02/04
GlTY OF YELM
COMNERGIAL BUILbING PERMITAPPLlCATION FORM }~ ~/~7~ ~I
Project Address: ~ ` - Parcel #: / ~3~ ~ O~ ~ I ~ V
/ - -^ ~--
Zoning; Current Use: Proposed Use: _ ` ~ ~C~
--~ -
LJ New Construction lW Re-Model / Re-Roof /Tenant Improvement yp`' ~L~
~Q Plumbing !~ Mechanical U Flre Prevent/Suppress/Alarm U Other ~ 1,
Project pescxiptlon/Scop6 of Work: ~~F
Project Value: ~ a-
6uflding Area (sq. ft) Parking Garage 1'" Floor_~2nd Floor 3'~ Floor
building Height
Are there any environmentally sensitive areas located on the parcel? If yes a
completed environmental cheddist must accompany permit application.
CITY
Copy of Clty Mklgatiorr documentation (TFCj.
I hereby certify that the above information Is correct and that the constructlon one and the occupancy and the a of the
above dexcribed property will he In accordance wkh the laws, rules and rayulatlons of the State of Waahingten~and the
City of Yelm.
AppilCant's Signature Date
Owner !Contractor /Owner"s Agent /Contractor's Agent /Tenant (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
IOS Yelm Auanue
,PO Bos 4T9
Yelm, WA 98S9T
a'`r",`' . a PPI;q~~egS~p .Goy
GAS REPA /R Service Order
P. O. Box 8610
Lacey, Wa. 98509-8610
(360) 491-9303 .~
^ SERVICE ^ ESTIMATE REPAIR IN ATE ORDERED
^ INSTALL ^ HOME ^OTHER ' ~ ~~
Name ~ ~
Address ~ ~^ ~.1~~ Phone
m IIIIII~
~ z
~ ~.
n ~ ~ ~
~,
~
~ I-
n ~ c
A ~
C 0.t (D (D
_ O N
tD ~ O
O
~ ~
w
~ a O ~ cD ~
z
I o . c~
~
~
to ~
~
o o _<
tD
~
r w a ~'
T~ 1
~ +
= MO 'v^^i N
t
W W W
D N ~ o W -°
»
-
~
tn s~ N o w ~
~ ~ w w w ~
~ °
~ o~ m
~
~
A fD
City
State Zip
MAKE MODEL SERIAL NO.
Service Requested:
OUAN PART NO. DESCRIPTION PRICE AM
OUNT
p
~ S ~'
'f~ S-~ S M ~O f C. s
j ~ I ~ ~.-III. ~ co 1 r`
SERVICES PERFORMED
N ~ ~ 4 -~
rya w
MlNays
~L ~ ~ S rj to a mlMa
TOTAL
MATERIAL
LABOR AN
°~
S o
~~ Yt.,.-~ ~C2~ SERVICE
1
p
1rZ V VJ ~- K.+~ ~.-er.~-~( TAX •~
TOTAL
I haiuh.. ar.-e..~ .~....... ....w...~-___ __.' _. _ g ~t1S
Customer Signature
i sausiaaory ana ac~nowtedge that equipment has been left n good corWrtion.
2, tne~
THANK YOU Technicians Signature
PUGET
SOUND
ENERGY
COMMERCIAL DATE ^ EXISTING
GAS SERVICE AGREEMENT I " j NEW CONSTRUCTION
/1pro~msnt Is iubJ~ct to rovlraw
K not valldat~d by PSE within 90 dsva.
.fir,;- '' OWNER PRO
CUSTOMER (tf euetornsr la an LLC, slbch Mst d partners namFe, ao cress. x F~, n • :umbers, PERTY INFORMATION
iN°'. r i S ,- NO ~`~ "° ~`
.,,
/V(!RK PHONE _
OTHER PHONE
j `" _ ~JOW NER
1 ~ ~ 1 IY~-~- ~ 1~ t• ~ ~ ^TENANT
DATE
SERVICE ADDRESS GTY
\ ZIP SQUARE FEET
I ' ~ ~ 1 ~ ~ ~ `•.V l• ~ ~'~~ ~ ~-l ~) ;~ fir'
MAILING ADDRESS CITY STATE ZIP
DOING BUSINESS AS TYPE OF BUSINESS
CONTACT NAME WORK PHONE OTHER PHONE
MAILING ADDRESS ~ CITY STATE ZIP
GA9 EpU1PMENT TO dE INSTALLED WRHIN 12 MONTHS OF METER INSTALLATION.
GAS USAGE @TUMR ANNUAL THERMS SKETCWREMARKS: N
^ SPACE HEATING ~ r '`'' 1) I .:( I• (. ! . ~ . 1_..:
^ WATER HEATING
Q COOKING r
PR
~ ` / I \N1 I ~ ~ l 1.-~ ~ ~: ~ J
^
OCESS
^ DRYERS
^ OTHER
^ OTHER
CONNECTED LOAD TOTAL
DELIVERY PRESSURE REQUESTED ~e 6" W.C. ^ PSI
-T
~IDFfICE USE
MAIN,. SERViC,~ 3 METER ~•~ "; 1~AAlN LENGTH - ~'
s~ ~:;°_
51:32VYCE ~1±fE~PR; ` M,.' ~ `• '~ `'^" nr° 3 ~ ~ Y~ ~'r '
S
" ~
SERVICE ONLY , - . ~ SERVICE LENGTH ,,._;'~ `
METER ONtY ' , METER 512E A 2 ~ u > `
ADDED LOAt7 CFH
EXISTING LOAD CFH -*7
~ ;t~ ~._
•
/} ! .~ ~ ; 6~
~± TIE IN JOB ~ (~1.' "
Z. (J'l,
/
/ ~ C/
cJJ_
,~ : , /
L i
~'' ~ FACILITY EXTENSION ,f, _ .. :?I" ,LVjit,}!t ~.~ ACTUAL CHARGES
^ EXCESS FLOW VALVE , s . ,^~ ` ... ~_ - ,,, ,. ,
CUSTOMER ADVANCE (NQT To ExcEEO s I oR ; ---
^ QUALIFICATION PAYMENT (NQT TQ ExcEED S I AND S
^ NEW CUSTOMER RATE scH tom f ~ Therm up to 5 years. Owner agrees to notify future owner and/or tenants of the new
customer rate. This rate is su lemental to other a livable rat
r.: ': J" 1 • d. M. '. 1~ ..1 R. e schedules.
^ QUALIFICATION PAYMENT (TERMINATE NCR) ~ ' r
~
.
l
S , _, :
CUSTOMER ADVANCE (ELIMINATE NcRI f
TOTAL CHARGES i .1 `Q
AMOUNT RECEIVED _ ,, _
BALANCE DU E i i'
T TERMS ~. ..~h t,~,,; t;..,
Amount Recd. $ Check No. Balance due $ _ $
q
8 per month for
`w:i
;
~~ months.
-~.
.+:=p
:~•. .. _ _ ,.c= ,
TOMER ACCEPTANCE dr
IT IS AGREED AND DECLARED THAT THE TERMS AND CONDITIONS SET FORTH HEREIN AND ON THE REVERSE HEREOF ARE PART OF THIS AGREEMr_N7 AND (i1NbINC; c!:~c-, r, niF F°nF?T iE5
HERETO. CUSTOMER GRANTS PERMISSION FOR COMPANY TO ACCESS CREDIT INFORMATION wHEN NECESSARY THIS AGREEMENT IS NOT V
ALID UNTIL
ACKNOWLEDGES~+1~ RE
C61P7 F COPY
~ THIS AGR 'EMEN'[. ~ ~ ACCEPTED BY PSE. CUSTOMER
)}
//
SIGN HERE ~C~L ~. ~~_ l •. ~L~~c~~ -~ `~ " ~ ~ ~=` . !~ ~'L> F /
/~-~
~_ /l - --/~ `"C ~~
O yyy~~FjjjE
RTr
ENANT PRINT NAME DATE
. ~ _
CLX CONSUMER NO. CLX STATEMENT ACCT.NO. CLXlSUBACCOUNT NO. NOTIFICATION NO.
SAP ORDER NO.
_
SAP RULE 7 CONTRACT NO. SAP BILLING DOC. NO. SCHEDULE DATE RATE 1 TOWN TAX CODE (Trf NCODE)
l
~ . ( l
re
PLAI NO _ SIC /MULTIPLIER ROUTE FIA % PERSON RESPONSBLE
t 3ti0 11-03
rvrn rc. rx ~~rv I rw1 rlLts GArvAKY: F'St HEPHESENTATIVE PINK:
PUGET SOUND ENERGY a subsidiary of PUGET ENERGY