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20050122 Permit Pkg 05132005City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Applicant: Name: Washington Energy Service Address: 2800 Thorndyke Ave. W City: Seattle Property Information: Site Address: 1307 Chrystal Springs Road Assessor Parcel No. 22718330302 Subdivision Contractor Information: Name: Applicant Contact: Address: City: Contractor License No: Expires: Project Information: Project: Mark Ziebell Description of Work: 2.5 Ton Heat Pump Permit Ivo: M-05-0122-YL Issue Date: 05/13/2005 (Work must be started within 180 days) Receipt No: 36736 Phone: 206.282.4700 State: WA Zip 98199 Phone: State: Zip: Business License: Sq. Fi. par floor: (1st) 0 (2i~d) 0 (3ru) 0 Garage 0 oasemer~t 0 Heat Type (Electric, Gas, Other): Lot: Fees: Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc Mechanical Permit 33.25 0.00 0.00 0.0000 0.0000 TOTAL FEES: 533.25 Applicant's Affadavit: i 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 W mgton. Final Inspection: Signature ' ~ ~ Date ~ Date: g -~ ~ ~~~~~~' f Firm ey. ~ol~'U ~,~ ~~1 QED dirt ~ ~ ~~ 7(J!~~ ~ 30~ / J' `~ J'pr l ~ ~ ~ ~ ~~a t _~ ~~~f ~ - y~ c~d~' ~~as-oi~L-yL ~`~ ~3 3.Z~ ~G~ C~ z~,~ ~ r~vt ~ '~ ~ -fh ~ . ~~ ~ - y ~~~ ~~~c~ Q`%z~~~ J y~-- ~o~T~p MEMORAND UM d City of Yelm YELM Community Development Department wnsHlwcTOw To: Washington Energy Service Attn: Candice Gallagher From: Roberta Allen Date: May 16, 2005May 16, 2005 Subj: Mechanical Permit Enclosed please find the receipt for payment of the Mechanical Permit M-05-0122-YL for an electric heat pump at 1307 Crystal Springs Road NW in Yelm, WA. Also please f~...J +4... ..+: ~.J t.. .a: .a aL_ :a._ In 14 U 1{V II IJfJGVIIVI l Vql V IVI ~./VJlll ly Ql U IC .711C. Please sign the enclosed permit page, at the bottom, in BLUE ink. Retain a copy for your office and return the original to our office at: Community Development Department City of Yelm P.O. Box 479 105 Yelm Avenue West Yelm, WA 98597 Applicant: City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Permit rvo: M-05-0122-YL Issue Date: 05/13/2005 (Work must be started within 180 days) Receipt No: 36736 Name: Washington Energy Service Phone: 206.282.4700 Address: 2800 Thorndyke Ave. W City: Seattle State: WA Zip 98199 Property Information: Site Address: 1307 Chrystal Springs Road Assessor Parcel No. 22718330302 Subdivision: Lot: Contractor Information: Name: Applicant Contact: Phone: Address: City: State: Zip: ~ .............. ~ : .. ~1.,. ••••, ,.~...•.•.~ "••..~,.... ~•... ~wNiica. DU~IIIC„ LI(:CIIJe. Project Information: Project: Mark Ziebell Description of Work: 2.5 Ton Heat Pump Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0 Heat Type (Electric, Gas, Other): Fees: Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc Mechanical Permit '33.25 0.00 YY0.00 0.0000 0.0000 TOTAL FEES: E33.25 :.ppicant's Affadavit: ;~ that I have read and examined the information contained within the application and know the same ;r_e end correct. I also certify that the proposed structure is in conformity with all applicable City of r~o~!t=:;ions including those governing zoning and land subdivision, and in addition, all covenants, em~.~ts and restrictions of record. If applying as a contractor, I futher certify that I am currently rr ~~ tared in the State of Washington. Signature Date Firm # Sets of Prints: Final Inspection: Date: By: ~~~ °` "'~ F~°~I CITY OF a m YELM ~ P.O. Box 479 Yelrn, WA 98597 YELM 360-458-8403 RECEIVED """"THIRTY THREE DOLLARS & ?. 5 CENTS RECEIVED FROM DATE REC. N0. 6t~ASHINGTCiN ENERGY SERVICES 05/13/05 36736 280© THORNSYKE AVE W SEATTLE YJA 9819y SITE 13074 CRYSTAL SPRINGS BUDGETARY }-TECH. PERMIT 33,25 RECEIPT No. 3 6 7 3 6 AMOUNT 33.25 CHECK REF N0. 4688 City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Permit Fees Schedule Permit No: M-05-0122-YL Applicant: Name: Washington Energy Service Phone: 206.282.4700 Address: 2800 Thorndyke Ave. W City: Seattle State: WA Zip 98199 Project Information: Project: Mark 2iebell Description of Work: 2.5 Ton Heat Pump Site Address: 1307 Chrystal Springs Road Assessor Parcel No. 22718330302 Fees: Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc --------------------------- -------------- ----------- ----------- ----------- ----------- ----------- ------------- MechanicalPermit 032 001-322-10-00 33.25 0.00 0.00 0.0000 0.0000 TOTAL FEES: 533.25 -~ i ~` PAID ~` ~IAY 1 ~ 2005 CITY OF YELM 3 b7~~~ ./ ;~RPR-28-2005 2 :14 FROM: T0: 13604533144 P.1 CITY OF YELM RESIDENTWL BUILDING PERMIT APPLICATION FORM Project Address: ! 3D7 i~,~a1 SP~r~~J,~ Parcel #:2~ 7 !~ 3 3 ~ 3a2 4.~ Subdivision: Lot #: ~ Zoning; I New Construction -Model / Re-Roof /Addition I I Home Occupation Sign I Plumbing echanical ` IM,,obile /JManufactur/ed Home Placement Other Project Descr~tion/Scope of Work: ~~T~-~ 1 `~CL~/,Gr`Lt~J 2 `~'7~1 Project 3,(~lp2~v~ Building Area (sq. ft) 1" Floor 2nd Floor Garage Deck Basement Carport Patio # Bedrooms- # Bathrooms- Healing: GAS/OTHER o ELECTRI irde One) Are there any environmentally sensitive areas located on the parcel? If yes, a completed environmental checklist must accompany permit application. BUILDING OWNER NAME: ADDRE S o C i'I U CITY TATS IP TELEPHONE ARCHITECT/ENGINEER LICENSE # ADDRESS CITY STATE ZIP TELEPHONE GENERAL CONTRACTOR TELEPHONE ADDRESS CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE_C11Y LICENSE # PLUM8ING CONTRACTOR TELEPHONE ADDRESS CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP PATE CITY LICENSE # MECHANICAL ONTRACTOR f~ ELEPHONE~- ~ ADORES 00 ~~r' L Gc14. l CITY ~ ti STATE W ZIP FAX CONTRACTOR'S LICENSE # S EXP DAY LICENSE # Copy of mitigation agreement with Yelm Community Schools, if applicable. I hereby oertliy that the above Informatlon Is coned and that the wnstrudlon on, and the occupancy and tha use of tho alwvo descrltwd property will tw In accordance with tho Taws, ruloa and rogulatlons of !ho $tato of Washington and the City of Yelm. ~ /~~~ ~~ ~ ^ pp ieant's Signature Date Owner /Contractor / Owne s Agent ontractors Agen ( ease 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 H work is suspended or abandoned for a period of 180 days I D ~ ~ '~ ~~\ ~v 3 ~ J V JV ~3 lt:\Coeunumry Devebpm~ntlForres & ProcedureslBuilding Petmi~s\RrsBldgPermi Wpp.doc Page 2 of 3