20050036 Permit Pkg 02042005City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: Fast Water Heater
Address: 12601 132nd Ave NE
Property Information:
Site Address: 916 Crystal Springs Road
Assessor Parcel No. 22719210300
Contractor Information:
Name:
Address:
Contractor License No:
City: Kirkland
Subdivision:
Contact:
City:
Expires:
Project Information:
Project: Gaye Water Heater
Description of Work: Remove/replace electric water heater
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other):
Fees:
Item
---------------------------
Plumbing Permit
TOTAL FEES:
Applicant's Affadavit:
Item Fee Base Amt
----------- -----------
27.00 20.00
$27.00
Permit No: PL-05-0036-YL
Issue Date: 02/04/2005
(Work must be started within 180 days)
Receipt No: 35483
Garage 0
Unit Fee Unit Rate
----------- -----------
7.00 7.0000
Phone: 425.814.3124
State: WA Zip 98034
Lot:
Phone:
State: Zip:
Business License:
Basement 0
No. Units Unit Desc
----------- -------------
1.0000 Fixture
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. ,1
Signature ~L^G~l~ ~~~L~ir/ Date ° C~ ~,~
Firm ,~TL~ ii .Q ~.r v~~~.~PC/
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspe~c~ti~oJn~:
Date~~~' U //~
By:~
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Applicant:
Name: Fast Water Heater
Address: 12601 132nd Ave NE
Property Information:
Site Address: 916 Crystal Springs Road
Assessor Parcel No. 22719210300
Contractor Information:
Name:
Address:
Contractor License No:
City: Kirkland
Subdivision:
Contact:
City:
Expires:
Project Information:
Project: Gaye Water Heater
Description of Work: Remove/replace electric water heater
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0
Heat Type (Electric, Gas, Other):
Fees:
Item
--------------------------
Plumbing Permit
TOTAL FEES
Item Fee Base Amt
----------- -----------
27.00 20.00
527.00
Unit Fee
7.00
Permit No: PL-05-0036-YL
Issue Date: 02/04/2005
(Work must be started within 180 days)
Receipt No: 35483
Garage 0
Unit Rate
7.0000
Phone: 425.814.3124
State: WA Zip 98034
Lot:
Phone:
State: Zip:
Business License:
Basement 0
No. Units Unit Desc
1.0000 Fixture
~~~~~
~~
~~
~n
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 Date
Firm
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Permit Fees Schedule
PAID Permit No: PL-05-0036-YL
FEB 0 4 2005 /
YELM ~~- ~ ~( ~~
CITY OF
Applicant:
Name: Fast Water Heater
Address: 12601 132nd Ave NE City: Kirkland
Project Information:
Project: Gaye Water Heater
Description of Work: Remove/replace electric water heater
Site Address: 916 Crystal Springs Road
Fees:
Phone: 425.814.3124
State: WA Zip 98034
Assessor Parcel No. 22719210300
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
--------------------------- -------------- ----------- ---------- ----------- ----------- ----------- -------------
Plumbing Permit 032 001-322-10-00 27.00 20.00 7.00 7.0000 1.0000 Fixture
TOTAL FEES: E27.00
• • • ~ - • r • - - • •
._ __ _ _
~ !$~JE="Ep99' CITY OF
1 T YELM
P.O. Box 479
Yelm, bVA 98597 RECEIPT No. •~ 5 4 8 3
YELM 360-453-8403
RECEIVED
****TWENTY SEVEN DOLLARS & 00 CENTS
RECt=!VPD F;iO~^~A DATE REC. N0. A~r1~JUNT RPM. ~;C~.
FAST WATER HEATER COMPANY 02/04/05 35483 27.00 CHECK 2014
12601 132ND AVE NE
KIRKLAND, WA 98034
1-800-454-8955
iLiISCELLANEOUS RECEIPT
GRETCHEN
PL-05-0036-YL
~~
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iv
/ d~
CITY OFYELM ' , `} _ `'-~v
RESIDENTIAL BUILDING PERMIT APPLICATION FORM 'f
Project Address: 916 Crystal Spring Rd Parcel#: 22719210300
Subdivision: Lot #: Zoning;
^ New Construction ^ Re-Model / Re-Roof /Addition ^ Home Occupation Sign
>~ Plumbing ^ Mechanical ^ Mobile /Manufactured Home Placement ^ Other
Project Description/Scope of Work: Remove/ replace electric water heater
Project Value: 3 4 9 _ 0 ~
Building Area (sq. ft) 1$` Floor 2"' Floor Garage Deck
Basement Carport Patio
# Bedrooms- # Bathrooms- Heating: GAS/OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel?
completed environmental checklist must accompany permit application.
If yes, a
~CJI:LQING.QWNEEt~:NAM,E: Randy Tanya Gaye
ADDRESS 916 Crystal Spring Rd '
CITY Y@lm~ STATE wA ZIP 98597 TELEPHONE.3~n_a5..~?p~ R
ARCHI7ECT(,I<IyG..,.I.fVEE_F( LICENSE #
ADDRESS
CITY STATE 21P TELEPHONE
Fast Water Heater TELEPHONE 425-814-3124
CITY Kirkland STATE WA ZIP98034 FAX 425-814-9516 _
CONTRACTOR'S LICENSE # FASTWHCO 5 2]?1~CP DATE CITY LICENSE # n ~ - n n 1 n a f
2-16-07
PLUMBING_COI~CTRACT;QR TELEPHONE
ADDRESS
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE
Copy of mitigation agreemeht with Yelm Community Schools, ff applicable.
I hereby c®nity 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.
~/~ >
Applicant's Signature D~
Owner / Cont~ act9c /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 18o days of issuance, or if work is suspended or abandoned for a period of
180 days