20100181 Permit Pkg 09142010City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Applicant:
Name: AIR SOLUTIONS
Address: 8746 CULLENS ROAD
YELM WA 98597
Property Information:
Site Address: 506 FIRST STREET
Assessor Parcel No.:
Contractor Information:
Name: AIR SOLUTIONS
Address:
8746 CULLENS ROAD
YELM WA 98597
Contractor License No.:
Project Information:
Project: MECHANICAL
Subdivision:
Permit No.: 20100181
Issue Date: 9H 4/2010
(Work must be completed within 180 days)
Phone: 360-400-1492
Owner: ST. COLUMBAN CHURCH
Lot:
Phone:
Expires: 0/00/0000
Description of Work: REPLACE 3 GAS FURNACES AND 1 HEAT PUMP SYSTEM VALUE $13,000
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
AIR SOLUTIONS
TOTAL FEES:
Applicant's Affidavit:
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 further certify that I am currently
registered in the ~efte of Washingtop. ,
Firm
Date
Fees
$ 73.00
5 73.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
--
City of ~el~
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REG#: ?it-40050 ~'!14!t414 1:~4 RM
OF'ER: G4 TERM: 401
REF#: JH
TRAi~: 3.4040 -UIL-I~lG F'ERi~IT5
4140181 ? ~ ° 44CR.
AIR SOLUTIOf~S
Pik, FIRST ST4EET
HEGH `:a.44GR
TE'ri-ERE- ~ ?3.40 OTHER
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CITY OF YELM
J~,-CEO I~I~/RC~p~. BUILDING PERMIT APPLICATION FORM
• Project Address: S l~c~.-t ,~O„ Parcel #:
Zoning, Current User ~f~~ ~ Proposed Use:
`i New Construction -~ Re-Model / Re-Roof /Tenant Improvement
~ Plumbing .~101echanical =Fire Prevent/Suppress/Alarm Other
Project Description/Scope of Work:~~,<<,,,Q ~ yn S f~ ~r.,~cr- f or ~ ~ `i~~~~u,..~ ~y~~.~.
Project Value: ~ ~ /~O ~
Building Area (sq. ft) Parking Garage 1 g` Floor 2"d Floor 3~d Floor
Building Height
•
C J
Are there any environmentally sensitive areas located on the parcel?
completed environmental checklist must accompany permit application.
BUILDING OWNER/TENANT NgME: ~~/,c C ~
ADDRESS D S~ S EMAIL
CITY ~-+ STATE L/ ZIP 4 TELEPHONE S 9 -/3 g-~
ARCHITECT/ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE_CITY LICENSE #
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE_CITY LICENSE #
MECHANICAL CONTRACTOR ~ TELEPHONE o ~ o - / Z
ADDRESS /o.~ EMAIL
CITY S/o •-• STATE /,IZIP ~14~ 59' FAX
CONTRACTOR'S LICENSE # ZEXP DATE_CITY LICENSE #
Copy of City Mitigation documentation (TFC).
I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the
above described property will be In accordance with the laws, rules and regulations of the State of Washington and the
City of Yelm.
/~,' /D
Applica 's Signature Date
Owner /Contractor /Owner's Agent /Contractor's Agent /Tenant (Please circle one.)
If yes, a
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
~vGSu V Lam' ,
CF 1 4 2010 1J
f
105 Yelm Avenue West
PD Box 479
Yelm, WA 98597
~3 Y:----------------- --
(360) 458-3835
(360) 458-3144 FAX
www.ci.yelm.wa.us