20120189 Permit Pkg 05292012City of Yell
Community Commitment BaParrmmt
Sullelne olvl.lon
Phone: 000) "84 7
Fax: (360) Sees 31"
Applicant
Name: ST. COLUMBAN CHURCH
Ardi 5051ST ST SO
YELM WA 88587
Permit No.. 20120189
Me* miurez mmpinea wMm legal
Phone.
Property Informal
She Metal 504 FIRST ST 5 Omer: ST COLUMSAN CATHOLIC
CHURCH
Assumear Partial No SYYAHMYn: Let,
Commercial Internalan
Name: ST. COLUMBIAN CHURCH Phone'.
Address.
ADS IST 6T SC
VIELM WA 0597
Carol Llcenes No.: Expires. 0.00NC0J
Project lnfomation:
Proles: PLUMBING
Oesorplar of Work'. REPLACE HOT WATER TANK
Sq. PE per floor Faro) Heal Tyze(EbLtac. Gas. Other)'.
Baron
Thing
Garage
Basement
Nam:
Imam CoMraIXor Fees
PLUMBING ST. COWMH CHURCH 8 25M
TOTAL FEES: E 2597
Appttum'sAmoma'
OFFI4YAL USC'INttY
reterHeI have read and eveminee IM irRermenm mmlrel earn the app5'atlm and mw the same
robe "a am coma l afar oral ueHlu arml umm"a o an Pedal wr a all applluem City a
y&teaPnrm_
Yam equal mIncluding 0oaa9oremins zoning am land rural maximal Hammel
and modelling a mated a applying as a mmratlar. l mdherxmy thn l am member
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REM 00095550
5/5/2012 8:18
CPER: M 7LRK:
001
REFR; LAM
IRANp120188W
BUILDING POE AIIS
ST. CDLWAN MRCH
504 FIRST
ST S
PL
n m
TENDERED:
25.W OTHER
APPLIED:
25.00"
CHANGE:
0.00
CITY EL
Y
OF M
COMMERCIAL BUILDING OF PERMIT EL APPLICATION FORM
• Project Address'. SCy s,cSf o3, Pa2N #'
Zoning', Current Use: Propmed Use:
E Nevi Conskuctron O R"odellRiEROOIITermaimprovement
ki Pumbing n Mechanical CC]] U Fire Preve1nVSuppresslAlarm o Other
Protect DamonptlorbSCOpe of Work: M1[R1nce
Protect Value: `� 7
•
•
AIA,gkq�
building Mae (w R) Parking Gerege_ - Floor 2 °Floor_r
Floor_
building Heigh
ADDRESS
Are there any environmentally Sensitive areas located on the panel9_
If we,a
completed environmental checklist must a iournpany permit aWficW*n.
ZIP
TELEPHONE
BUILDINGOWNERrrENANTNAAIE. SL o a.. o Z, .��
AGGRESS SOh Si Sr EMAIL
Cltt 4VI STATEWAZIP4p.5]�TELEPHONE 3 0- 5-
61r
EMAIL
ARCHITECTIENGINEER
LICENSER
ADDRESS
EMAIL
CITY STATE_
ZIP
TELEPHONE
GENERAL CONTRACTOR
TELEPHONE
ADDRESS
EMAIL
CITY STATE_ZIP
FAX
CONTRACTOR'S LICENSE#
EXP DATE_ORY LICENSE#
PLUMBING CONTRACTOR
TELEPHONE
ADDRESS
EMAIL
CITY STATE
—ZIP
FA%
CONTRACTOR'S LICENSE#
EAR DATE CITYUCENSE#
MECHANICALCONTRACTOR
TELEPHONE
ADDRESS
EMAIL
CITY STATE_ZIP
FAX
CONTRACTOR5LICENSE#
EXP DATE CITY LICENSE
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clo ad Y__lm��.
xEos: d. $ieyda SIe
pplkant'A BlpneW Dale
Owner l eomnctor Owner's Age Conbacior's Agent l Tenant (Please circle one.)
All permits am non- warlshrable and will expire If work authoNasd by such pemrk is not begun
within 10 days of Issuance. or Nwork h suspended or abandoned bra perbd d fad days
IN TeMAVenue cant
(no) ousudia9
P011e479 (d6n)4SeSl44 AdY
Yedn WA M597 wwa.eiytlm.mu.uv