20100229 Permit Pkg 12102010Applicant
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No.: 20100229
Issue Date: 12110/2010
(Work must be completed within 180 days)
Name: ELIZABETH WAGES Phone: 520-465-7745
Address: 16602 91ST AVE SE
YELM WA 98597
Property Information:
Site Address: 16602 91ST AVE SE Owner: ELIZEBETH WAGES
Assessor Parcel No.: Subdivision: Lot:
Contractor Information:
Name: TAHRAN AIR LLC
Address:
4912 68TH AVE NE
OLYMPIA WA 98516
Contractor License No.: TAHRAA69410F Expires:
Project Information:
Project: MECHANICAL
Description of Work: ADD HEAT PUMP
Sq. Ft. per floor:
First
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Phone:
4/22/2012
Heat Type (Electric, Gas, Other): GAS
Contractor
ELIZABETH WAGES
TOTAL FEES:
Applicant's Affidavit:
I certify that I have read and examined the inforrnation 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 State of Washington.
Firm
Date ~~~/o~/~
Fees
$ 29.50
E 29.50
of Prints:
Inspection:
Date:
By: _
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CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address:~a Q ~ ~ ~ V~ 5rE Parcel
Subdivision: Lot #: Plan #: Zoning:
New Construction i Re-Model / Re-Roof /Addition ~ Home Occupation Sign
Plumbing Mechanical Mobile /Manufactured Home Placement ~ Other
Project Description./S2co'pe of Work: ~n~_~~~~~is1tP
Project Value; -G~ 3 S . Zy
Building Area (sq. ft) 151 Floor 2"d Floor Garage Deck
Basement Carport Patio
# Bedrooms # Bathrooms- Heating: AySAy~THER or ELECTRIC (Circle One) Crx+~N Cy
Are there any environmentally sensitive areas located on the parcel?
If yes, a completed environmental checklist must accompany permit application.
BUILDING OWNER NAME: T~~i2y ~~65
ADDRESS /ST EMAIL
CITY YELn'i STATE~i4 ZIP TELEPHONE
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 #
CITY
LICENSE
Copy of mitigation agreement with Yelm Community Schools, if applicable,
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.
-~~~ / /6
Ap Icant's Si a re Date
Owner / Contrac or /Owner'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 180 days
705 Yelm Avenue West
Yelm, WA 98597
www.ci.yelrn.wa.us
(360) 458-3835
(36'0) 458-3144 FAX