20130117 Permit Pkg 02042013 'o�o�T"����� City of Yelm Permit►vo.: 20130117
'� Communi Devel
� ,. o ment De artment
tY p Iss
a en
P ue Date: 2/04/2013
ork m
ust be com leted within 1
. . M� p 80 da s
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Building Division
Phone: (360)458-8407
L
w�'`"�"`� " FBX: (360)458-3144
Applicant:
Name: FAIRWAY REAL ESTATE CO Phone: 2532027164
Address:
P.O. BOX 2703
YELM WA 98597
Property Information:
�I'I
Site Address: 413 MCKENZIE ST SE owner:
Assessor Parcel No.: Subdivision: Lot:
Contractor Information:
Nam • .
e. FAIRWAY REAL ESTATE CO
Ph
one.
A
ddress: C/O RICH
SIMMONS
P.O. BOX 2703
YELM
WA 98597
Con r
t actor License No.:
Ex ires: 0/00/0000
P
.
Project Information:
Project: ROOF
Description of Work: OVERLAY ROOF
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor
Fees
ROOF FAIRWAY REAL ESTATE CO $ 25.00
TOTAL FEES: $ 25.00
ApplicanYs Affidavit:
I certify that I have read and examined the information contained within the application and know the same OFFICIAL USE ONLY
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 in the tate f Washington.
Signature Date .� ( � Date:
Firm BY:
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City of Yelm
(360) 45B-8402
REC#: 00118281 2/04/2013 2:19 PM
OPER: CO TERM: 001
REF#: 1007
TRAN: 33.0000 BUTLQING PERMITS
20130117 25.00CR
�� FAIRWAY REAL ESTATE CO
413 MCKENZIE ST SE
ROOF 25,OOCR
TENDEREQ: 25.00 CHECK
APPLIEp: 25,00—
CHANGE: ��� 0.00
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CITY OF YELM
� RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: � �'/�� �`j�� ,p,�Z,,,���i�'arcel#:
Subdivision: Lot#: Plan#: Zoning:
! � New Construction � i Re-Model/Re-Roof/Addition Home Occupation Sign
i Plumbing Mechanical � Mobile/Manufactured Home Placement � Other
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Project Description/Scope of Work: Ch �iv� .� �.e,.�,1i,.�^ (��oi
t3-O
Project Value:��r
Building Area(sq. ft) 1S` Floor����2�d 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?
/fyes, a completed environmental checklist must accompany permit application.
BUILDING OWNER NAME: �.
ADDRESS `� f� . � 'tr EMAIL
CITY STATE • ZIP TELEPHONE
ARCHITECT/ENGINEER LICENSE#
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERALCONTRACTOR� CG� rC��ELEPHONE/ � y � y,Q2..7/cy
ADDRESS �' ` -���. �1, EMAIL .
CITY STATEW ZIP ' FAX��;b z-l0�– �tp7.i/
CONTRAC OR'S LICENSE# XP DATE C(TY 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.
C�1J�[��v ' ' ��.P��./E�G�L.l._..,
Appiicant's Signature Da e �
Owner/Contractor/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 180 days of issuance, or if work is suspended or abandoned for a period of 180 days
�
105 Yelm Auenue West
(360)458-3835
Yelm, WA 98597 (360)458-3144 FAX
www.ci.yelm.wa.us
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Duct Leakage A.ffidavit
Permi##: 2� �� � .3 ��
Fiouse address or lot number:____��I�GI�__�������C� ��
�
Clty: —��-�-�-��� --- Z�p� _-��c���_
Cond. Ffoor Area (ff2):___�__��_1 __ Source tcircle one): PJ��fis`� Estirriated Measured
❑Duct tightness testing is not required for this residence par exceptions listed at the end of this document
Air Handler in conditioned space? ❑yes [�no Air Handfer present during test? �yes 0 no
Circle Tesf Method: Leakage to Outside al L.eakag
Maximurn duct leakage:
Post Construc#ion,total duct leakage: (ftoor area x A8)=_____CFM@25 Pa
Post Consfruction,leakage to outdoors: (floor area x.06)__ __CFM@25 Pa
Rough-(n,total duct leakage with air handler installed: (floor area x.06) =1�,�—�FM@25 Pa
Rough-!n,tofal ctuct feakage with air handler nof installed: (floor area x.04)=______CFM@25 Pa
Test Result:���___CFM@25Pa
Ring(circle one if applicable): Open 1 �-2-�� 3
Duct Tester Locafion:___�-��_`___ _ Pressure Tap Location:}��eJ`��'���?4?��
I cerEify that these duct teakage rates are accurate and determined using staE�clard duct testing proEocol.
Company Name:_��{�!�_�!!�_����___Technician:_��<����_����-
7echnician Signafure:��{�:_ Dafe:--�0 � Phone Number:__��L=U��
Washington Sfate Energy Code reference:
503.10.3 Sealing.All ducts,air handlers,filter boxes,and building caviiies used as ducts shall be sealeri.Joints and seams shall comply
�vith Sectfon M1609.3 of the Intemafional Residential Code or 603.9 of the lnternationa!Mechanical Cvr.l r. puct tightness testing shall be
conducted to verify that the ducts are sealed.A signed a�davit documenfing the tesk resulfs shall be pru�:ided to the Jurlsdlctlon having
authority by iha testing agent.When required by the bullding official,the test shall 6e conducted in the���,.�ence of department staff.
Exceptlons: 1.Duct tightnass test ts not required i(iha air handler and all ducis are located within cor,�:`��ned space.
2.Duct testing is not required'rf the fumsce is a nondirect vent type combustion applianr�: ,talled in an unconditloned space.
A maximum of six feet of connected duchvork In ihe unconditloned space is allor,ved.All::�'':tionaf suppty and return ducts
shalt be withln the condflioned space.Ducis outside the cond(tfoned space shall be seal�:� .�;ith a mastic type duct sealant and
Insulated on the exteriorvhth R-8 insulation for above grade ducts and R-5 vrater resistar�:;�:sulation when wifhln a slab or
earth.
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