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20130125 Permit Pkg 02212013 �O'�TH�A� City of Yelm Permit No.: 20130125 � � Community Development Department Issue Date: 2/21/2013 (Work must be completed within 180 days) Building Division Phone: (360)458-8407 '""`" '°" Fax: (360)458-3144 Applicant: Name: DALE BUTCHER Phone: 360-458-1019 Address: 15774 104TH AVE SE YELM WA 98597 Property Information: Site Address: 15774 104TH AVE SE Owner: DALE BUTCHER Assessor Parcel No.: 85840004200 Subdivision: YELM TERRA Lot: 42 Contractor Information: Name: FAST WATER HEATER Phone: 425-814-3124 Address: 12601 132 ND AVE. SE KIRKLAND WA 98034 Contractor License No.: FASTWWH9486C Expires: 1/04/2014 Project Information: Project: MECHANICAL Description of Work: REMOVE AND REPLACE GAS WATER Sq. Ft. per floor: First Heat Type(Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor Fees PLUMBING FAST WATER HEATER $ 27.00 TOTAL FEES: $ 27.00 ApplicanYs Affidavit: OFFICIAL USE ONLY I certify at I have read and examined the information contained within the application and know the same to be tr and correct. I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints: Yelm re ulations including those governing zoning and land subdivision,and in addition,all covenants, easem ts nd ictions of re o . If appl ing as a contractor, I further certify that I am currently ,- Final Inspection: register d i St te of W h t n. � Signatur Date Date: Firm By� Cit� of Y�lm (35 ) 458-8402 REC#: OQ120406 2/21/2013 1:37 PM OPER: CO TERM: 001 REF#: 14657 TRAN; 33.0000 BUILDING PE�MITS 20130125 27.00CR BUTCHER, QALE 15774 104TH AVE SE PL 27.00CR TENDERED; 27.00 CNECK APPLIED: 27.00- CHANGE, 0.00 �, i � . , 625375 CITY OF YELM ��'� � RESIDENTIAL BUILDING PERMIT APPLICATION FORM o�� Project Address:15774 104 AVE SE Parcel#: �� C� ��`�I �w Subdivision: Lot#: Zoning; �� New Construction ❑ Re-Model/Re-Roof/Addition ❑ Home Occupation Sign .' Plumbing � Mechanical ❑ Mobile/Manufactured Home Placement 0 Other Project Description/Scope of Work: Remove/Replace Gas Water Project value:� � � ��O Buiiding Rrea(sq.ft) 1$`Floor 2"d Floor Garage Deck Basement Carport Patio #Bedrooms_ #Bathrooms_ Heating GA /OTHER or ELECTRIC(Circle One) Are there any environmentally sensitive areas located on the parcel? If yes,a completed environmental checklist must accompany permit application. BUILDING OWNER NAME: BUTCHER DALE ADDRESS 15774 104 AVE SE EMAIL CITY YELM STATE WA ZIP 98597 TELEPHONE360 790-0512 ARCHITECT/ENGINEER LICENSE# ADDRESS EMAtL CITY STATE ZIP TELEPHONE GENERAL CONTRACTORFAST WATER HEATER COMPANY TELEPHONE_ �'��=�3�-70b-4T --- ADDRESS 12601 132ND EMAIL�'�x�a.fastwaterheater.com ��nKIRKLAND STATE ZIP 4 FAX 425-636-7055 CONTRACTOR'S LICENSE# FASTWWH948BC EXP DATE�i4i� ITY LICENSE# 1048 PLUMBING CONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE# ---�-- __ ._- -- ---- ---- ------ �MECHANICALCONTRACTOR TELEPHONE ' ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE# _ Copy of mitigetion agreement with Yelm Community Schools, if applicable. �'r�.:,euy c�s?i;y ii�ai tiie abova�nfurr:�ation is correcY 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. � 2/4/13 Applican ' re Date O:.�r7er Contractor/Owner's Agent/Contractor's Agent (Please circle one.) All permits are non-tr��nsferable and will expire if work authorized by such permit is not begun within 1 a0 days of issuance, or if work is suspended or abandoned for a period of 180 days --- ._._ ----------- ----- - ----- 10•i Yelrn�auenue West (360)458-38.?; I'0.13ox 47:1 (360)458-3141 k'AX Yelno, 4✓.� .985J7 www.ci.yelne.wa.us I _ _��,��VED I ; FEB 21 2013 � ��_ .�. � City of Yelm Permit No.: 20130125 � Community Development Department Issue Date: 2/21/2013 R (Work must be completed within 180 days) Building Division Phone: (360)458-8407 Fax: (360)458-3144 Applicant: Name: DALE BUTCHER Phone: 360-458-1019 Address: 15774 104TH AVE SE YELM WA 98597 Property Information: Site,4ddress: 15774 104TH AVE SE Owner: DALE BUTCHER Assessor Parcel No.: 85840004200 Subdivision: YELM TERRA Lot: 42 Contractor Information: Name: FAST WATER HEATER Phone: 425-814-3124 Address: 12601 132 ND AVE. SE KIRKLAND WA 98034 Contractor License No.: FASTWWH9486C Expires: 1/04/2014 Project Information: Project: MECHANICAL Description of Work: REMOVE AND REPLACE GAS WATER Sq. Ft. per floor: First Heat Type(Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor Fees PLUMBING FAST WATER HEATER $ 27.00 TOTAL FEES: $ 27.00 ApplicanYs Affidavit: OFFICIAL USE ONLY I certify at I have read and examined the information contained within the application and know the same to be tr and correct. I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints: Yelm re ulations including those governing zoning and land subdivision,and in addition,all covenants, easem ts d ictions of re o . If app ing as a contractor, I further certify that I.am currently Final Inspection: register d i St te of W t n. Signatur Date I Date:� �� Firm By: gCpNNED MAR 2 o zo�� Cit� af Y�lm (36 ) 458-8402 REC#: 00120406 2/21/2013 1 :37 PM OPER: CD TERM: 001 REF#, 14657 TRAN, 33.0000 BUILDING PERMTI"S 20130125 27.00CR BUTCNER, DALE 15774 104TH AVE SE PL 27.00CR TENDERED; 17.00 CHECK APPLIED; 27.00- CHANGE: 0.00 625375 � , RESIDENTIAL BUILDING PERMI APPLICATION FORM oGV�� Project Address:15774 104 AVE SE Parcel#: �� t� ��v'�W 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 Gas Water Project Value:' � � ��O Buiiding Area(sq.ft) 15�Floor 2"d Floor Garage Deck Basement Carport Patio #Bedrooms_ #Bathrooms_ Heating GA /OTHER or ELECTRIC(Circle One) Are there any environmentally sensitive areas located on the parcel? If yes, a completed environmental checklist must accompany permit application. BUILDING OWNER NAME: BUTCHER DALE ADDRESS 15774 104 AVE SE EMAIL CITY YELM STATE WA ZIP 98597 TELEPHONE360 790-0512 ARCHITECT/ENGINEER LICENSE# ADDRESS EMAIL CITY STATE ZIP TELEPHONE GENERAL CONTRACTORFAST WATER HEATER COMPANY TELEPHONE - - � ADDRES512601 132ND EMAILQp-�''��ic.fastwaterheater.com CITYKIRKLAND STATE ZIP 4 FAX 425-636-7055 CONTRACTOR'S LICENSE# FASTWWH9a8BC EXP DATEii4i� ITY LICENSE# 1048 � PLUMBING CONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX_ CONTRACTOR'S LICENSE# EXP DATE_CITY LICENSE# �MECHANIC/�L CONTRACTOR TELEPHONE ' ADDRESS EMAIL CITY � STATE ZIP FAX . CONTF'.ACTOR'S LICENSE# EXP DATE_CITY LICENSE# Copy of mitigation agreement with Yelm Community Schools, if applicable. i��<:;euy c�,'si;y inai tiie abava iniurrnaiion is correc2 and that the�onstruction on,and the occupancy and the use of the above described property will be in accordance with the laws,rules and regulations of the 5tate of Washington and ihe City of Yelm. 2/4/13 Applican '- re Date O:.ner Contractor/Owner's Agent/Contractor's Agent (Please circle one.) Ali permits are non-tr�nsferable and will expire if work authorized by such permit is not begun within 1 a0 days of issuance, or if work is suspended or abandoned for a period of 180 days I0;Yelrn�avenue West-------! -- -- --_ (360)458-383 i 1'()13ox 4%:1 {360)458-314�F',r1X Yelne, Y✓4 .935J7 www.ci.yelnc.wa.us I�.::-��'FIVED i ; FEB 21 2013 ��_:�.�.