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20120315 Permit Pkg 11132012 �QF rtN�P� City of Yelm Permit No.: 20120315 � � � �, Community Development Department Issue Date: 11/13/2012 (Work must be completed within 180 days) Building Division Phone: (360)458-8407 L ""`""'°'°" Fax: (360)458-3144 Applicant: Name: THOMAS A MILLER Phone: 360-400-0970 Address: 15202 CARTER LP SE YELM WA 98597 Property Information: site Address: 15202 CARTER LP SE Owner: THOMAS MILLER Assessor Parcel No.: 52920003800 Subdivision: Lot: Contractor Information: Name: PRATTS PLUMBING Phone: 360-357-3262 Address: PAMELA PRATT 3301 46TH AVE NE OLYMPIA WA 98506 Contractor License No.: PRATTPF9900D Expires: 7/29/2010 Project Information: Project: PLUMBING Description of Work: REPLACE EXISTING NATURAL GAS WATER HEATER WITH SAME Sq. Ft. per floor: First Heat Type(Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor Fees PLUMBING PRATTS PLUMBING $ 27.00 TOTAL FEES: $ 27.00 ApplicanYs Affidavit: 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 further certify that I am currently Final Inspection: registered� State o shington. � � Date: Signature Date 3 �� / 1 ' gy. Firm � Cit� of Y�lm (�6 ) ��s-��o� REC#: U01107I� 11/13/1U12 3:46 pM 7PER: CO ItRM; �101 RFF#; 617b �IRAN; �iJ�U0U0 �UILGINIa PERMI7S ?01203�i 5 27.O�t;R Mll.l.Eh, TfiQMA� A 15'lCi2 CARTER l.p SE Pl. 27.OUCR I k�N[�kC�EI�: ;�l.OQ t;Hk:(',K AF�'L:IED; 27000- _�_..._.__.._ CHANGE: � U,oO �,D��i � �l � CITY O�Y��,M . � �31DE IAL BUILDIN(3 PERMI'I'APP�.ICATiON I�ORM � � Pro)ect d►ddress: � Parcel#: y _ _ �Q (� Su�dlvisl<tn: ' Lot�F: � zoning� , � -- ,..... �,? �t�u+i�eonst�ucf n ' ::] e�Model!Re-Roof!AddiEian (.:, Hame Occupatlnn Sign �"��Plumbing M h�nical '-i Mablle/Manufactured Home Placement �7 Other Pro)ect Deacnptio Sc� e'of Wo : �„�I�S�� ProJect Value: ' Bullding Rrea{sq.ft) °�FlOOr 2"d Floor C��rage � Deck Raseme t Carport__ . patia #B�drooms_ �Bath ms_ Heating:GAS/QTHER or ELECTRIC(Circle One) Are there any env fonm r�t�lly se sitive areas(ocafed on the parcel? If yes, a completed envl ment !checklE t must accompany permit appllcation. , �IJiI.ptNG 4WN I�NA E' ADDRESS S �MAIL CITY STA7� ZIP TELEPHON� ARChfET�CT/�N 1NE� ' !.lCENS�# ADDRESS �MAf� CITY S?'A�'� Z!P TELEPHON� � "�� G�N�RAL CpNT CT R TELEPMONE L ADI7R�SS EMAIL ClTY STA7"� ZIP�FAX CONTRACTOR'S ltC� SE# EXp DATE CITY UC�NSE# PLUMB}NG CON F2AC OR `C-�ELEPHON� !9 ADDRESS — r �MAIL Gt?Y STATE �II� FAX CONTRAC�`0 "S LtCE 8�# EXP DA7E7 iTY LIC�NSE# ,a M�CHANICAL C NT C`�OR TELEPNON� AdDRE55 CiTY EMAE� TATE zIP��FAX CONTRACYdR'S !CE S�# EXP DAT�i,,,ClTY 1�ICENSE# Copy of itiga on:agr �nt with Yslm Community Schaols, if applicable. !hsroby certKy that •abo t�lo�inat n!s corrgct and that the Cono4ruatlon on,apq ths occupancy snd tho uee of tho above d�sarlbad p rty w I b�In ee Irl�snc�with tha�ews,rulas and regulntlont of the StaCe of Weshington and the Clty Of Yelrtt. anYs Sign l 1 ( 1� 1�—.� � D�te Owne /Contract r! r�et's A ent�/Contractor's Agent (Please circle one.) AI!permiCs are n n-tra sf�rabl and wlll explre If work authorized by such parmit fs not begun wlthin 760 days o €ssu r�ce�o� f woirk Is suspended or abandoned for a perEad of 180 days 1Q5 Yelm Ave►ae�e F�'e e � � � (�8D1 438-888g PO Box 479 ����c—�-. (860)4GB-81a4 FAX Yclm,WA 9Xb97 IU '��f��... 1�1 e' � (j wu�w.ci,yelm.wa.��A . ° . ._,,,.Y,� �� 4,`J M L BY:------------------- T00� ' Z9Z�L�E09£ %�'3 Lb��O LOOZ/8Z/i0