20050113 Permit Pkg 04132005City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Applicant:
Name: Advanced Filter 8 Mechanical
Address: 418 Valley Ave. NW Ste. 8115
Property Information:
Site Address: 16410 Cascadian Ave. SE
Assessor Parcel No. 84070000800
Contractor Information:
Name:
Address:
Contractor License No:
City: Puyallup
Subdivision:
Contact:
City:
Expires:
Permit No: M-05-0113-YL
Issue Date: 04/13/2005
(Work must be started within 180 days)
Receipt No: 36147
Phone: 253.770.2440
State: WA Zip 98371
Phone:
State: Zip:
Business License:
Project Information:
Project: Ramirez A/C
Description of Work: 1 112 ton AIC and Electronic Air Cleaner
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0
Heat Type (Electric, Gas, Other):
Lot:
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
--------------------------- ----------- ----------- ----------- ----------- ----------- -------------
Mechanical Permit 39.00 0.00 0.00 0.0000 0.0000
TOTAL FEES: $39.00
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 Washington.
Signature a ~ Date ~''~'
Firm ~ By.
_._
~~~~ ~~,Fp~;,~ cITY or
~~ v
m YELM
P0. Box 479
Yelm. WA 98 x.97
YELM 360-458-8403
RECEIVED ****THIRTY NINE DOLLARS & 00 CENTS
RECf_:IVF:D FF?Ot,4 DATE REC. N0.
ADVANCED FILTER & MECHANICAL 04/13/05 36147
418 VALLEY AVE NW STE 8115
PUYALLUP WA 98371
RECEIPT No. ~ 6 i 4 7
AMOUNT REF. NO.
39.00 CHECK 11772
14ISCELLANEOUS RECEIPT
MICHELLE
MECH PERI~tIT SITE 16410 CASCADIAN AVE SE
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit Fees Schedule
Permit No: M-05-0113-YL
Applicant:
Name: Advanced Filter 8 Mechanical Phone: 253.770.2440
Address: 418 Valley Ave. NW Ste. 8115 City: Puyallup State: WA Zip 98371
Project: Ramirez A/C
Description of Work: 1 1/2 ton A/C and Electronic Air Cleaner
Site Address: 16410 Cascadian Ave. SE
Assessor Parcel No. 84070000800
Fees:
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
--------------------------- -------------- ----------- ---------- ----------- ----------- ----------- -------------
Mechanical Permit 032 001-322-10-00 39.00 0.00 0.00 0.0000 0.0000
TOTAL FEES: $39.00
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: I by 1(: ~ Cc: _Src. ~ ~ ~_-~ t~l,~r,5~ Parcel #: ~~/fi'7 O~('~ U ~ ~ J
Subdivision:
Lot #: Zoning;
u New Construction u Re-Model / Re-Roof /Addition u Home Occupation Sign
u Plumbing .@~-Mechanical u Mobile /Manufactured Home Placement u Other
Project Description/Scope of Work: Ac~ , mac. t~ ~r - ~ lr~ ~ .•^ c~~ ,~ ~ c ,l~ , ~ ~' 1N~.r-,r-~ .~-
Project Value: ~L~ 7 ~-1 7 - ~ `1
Building Area (sq. ft) 1~ Floor 2"d Floor Garage Deck
Basement Carport Patio S ,ct e y c ~ c~ _
# Bedrooms- # Bathrooms- Heating: GAS/OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER NAME:'"
ADDRESS ~L. ~ ~ - C'c s 4 cJ.c..: A.~. S 1:-' EMAIL
CITY `l,~ /~» STATE~ZIP ~.~ 517 TELEPHONE ~U. c> - ~/U!7 - C> `~~3
ARCHITECTlENGINEER LICENSE
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR i~t1.:~'nt.> ,l ~ ; If ~.~ U11~thTELEPHONE 7s3- 77G7~~7yyo
ADDRESS 41 ~'-t,' ~: tlr~_ A_~ ,~'~,;~ ~-- 3- EMAIL
CITY - ~ ESTATE l.~'c,~ ZIP ~r'y3 )/ FAX :5j ?7'c-•~yy 3
CONT CTO 'S LICENSE #.RD~';-.,t,'rlllc~,e¢~~l EXP DATE CITY LICENSE#
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable.
1 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.
Appl
/ Contractor /Owner's Agent /Contractor's Agent
_ ~ t ~f~ `~
Date
(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
105 Yelm Avenue Weat (360) 458-3835
PO Box 479 (360) 458-3144 FAX
Yelm, WA 98597 rvraru.ci.yelm.rua.ue