20120343 Permit Pkg 12272012 o�YH�'� City of Yelm Permit No.: 20120343
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D ment Issue Date: 12/27/2012
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(Work must be completed within 180 days)
Building Division
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Phone. 360 458-8407
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A licant:
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Name: FAIRWAY MOTERS Phone: 400-7000
Address: 1500 YELM AVE W
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ELM WA 98597
Pro ert Information:
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site Address: 1500 YELM AVE W Owner: FAIRWAY MOTORS
1 00 Subdivision: Lot:
Assessor Parcel No.: 9900 9664
r Inf rm tion:
Contracto o a
Name: AIR HANDLERS Phone:
Address:
PO BOX 4036
TUMWATER WA 98501
Contractor License No.: AIRHAI*230JJ Expires: 2/29/2012
Project Information:
Project: MECHANICAL
Description of Work: REPLACE GAS FURNACE LIKE FOR LIKE
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
Contracto
r Fees
MECHANICAL AIR HANDLERS $ 26.50
TOTAL FEES: $ 26.50
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ApplicanYs Affidavit: �� OFFICIAL USE ONLY
I certify that I have read and ex the' orrr�ati ncr c ained within the application and know the same
to be true and . o ose tructure is in conformity with all applicable City of #Sets of Prints:
Yelm reg ions inci ng se ov i zoni and an � n,and in addition,all covenants,
easem ts and r o re . If appl � g as contractor, I further rtify that I am currently Final Inspection:
registere ln e S � of Wa gton.
. , Date:
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Si natu Date
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Firm �1.� �)
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��ER� 35126 ����,ZS
RE�#� ��I�DINr' P
33.n000 �6,5�CR
�RPN 2012d3�3 Mp"(ERS
�AIRW y��M AVE W �pCk
15�0 2�.
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j ENDEREO; 26,50-
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CITY OF YELM
� COMMERCIAL BUILDING PERMIT APPLICATION FORM
; Project Address: 6� ��C��'�� � Parcel#:
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Zoning; Current Use: Proposed Use:
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I New Construction Re-Model/Re-Roof/Tenant Improvement
_: Plumbing �Mechanical Fire Prevent/Suppress/Alarm Other
� Project Description/Scope of Work: L��'t..A,� C� ���� �i�C� ��' �-i��
� Project Value:� ��5��,���
Building Area(sq. ft) �Parking Garage 1S`Floor 2"d Floor 3`d Floor
,
Building Height ��
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Are there any environmentally sensitive areas located on the parcel? If yes, a
icompleted environmental checklist must accompany permit application.
BUILDING OWNER/TENANT NAME: � 1'Gt�AY ��Jd ''
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
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� ARCHITECT/ENGINEER LICENSE#
i ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
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GENERAL CONTRACTOR �- TELEPHONE ��--- - �
l ADDRESS�- � :7i " EMAIL
� CITI�`Ul��/q�.� STAT 'F�c'�ZI _ FAX�;b�. ���-t-��
CONTRACTOR'S LICENSE#k�i�ri�x��EXP DATE�CITY LICENSE#Cl -E�t��4K
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE FAX
� CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
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� MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE IP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
; Copy of City Mitigation doc entation(TFC).
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I hereby certify at t above' formation is correct and that the construction on,and the occupancy and the use of the
I' abo �' pert"y"" -be-in-as with the laws,rules and regulations of the State of Washington and the
j ity of Y fn. : �-
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LLpplicant' —u�ie Date
Owner/ ontractor wner's Agent/Contractor's Agent/Tenant (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 Auenue West (360)458-3835
PO Box 479 (360)458-3144 FAX
Yelm,WA 98597 www.ci.yelm.wa.us