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07-0345 Permit PkgO~'"~A~~ City of Yelm Property Information: Site Address: 312 Mosman Ave. SW Assessor Parcel No. 21724411400 Subdivision: ~ Community Development Department Building Division Phone: (360) 458-8407 YELM Fax: (360) 458-3144 Applicant: Name. Washington Energy Service Address 2800 Thorndyke Ave. W City Seattle Contractor Information: Name: Applicant Contact Address: City: Contractor License No: Expires: Project Information: Project: Pamela Walker Description of Work: 40 gallon Hot Water Tank-gas 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 33,25 0.00 _ 0.00 TOTAL FEES: $33.25 Permit No: M-07-0345-YL Issue Date: 09/10/2007 (Work must be started within 180 days) Receipt No: 50298 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 Applicant's Affadavit: 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 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 Washin on. ~ Fii Signature / / `/~. N l ~~~~/~ ~ Date ~ ~ ~J ~ f Firm fv~/..~, .~/,~_ ~-~'4-'Gi. ~ I B =FILIAL USE ONLY i s of Prints: i Inspection: I i