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20130167 Permit Pkg 04112013 _ _ . woF TH�� City of Yelm Permit tvo.: 20130167 9 '�i Community Development Department issue Date: 4/11/2013 (Work must be completed within 180 days) Building Division Phone: (360)458-8407 L `""`"'"`�°" Fax: (360)458-3744 Applicant: Name: JERRY KAUTZMAN Phone: 253-753-6860 Address: 10438 BRIGHTON ST SE YELM WA 98597 Property Information: site Address: 10438 BRIGHTON ST SE Owner: JERRY KAUTZMAN Assessor Parcel No.: 65080008800 Subdivision: Lot: Contractor Information: Name: BLACK HILLS, INC Phone: 360-239-3776 Address: 1003 85TH AVE SE OLYMPIA WA 98501 Contractor License No.: BLACKH1066JL Expires: 3/31/2009 Project Information: Project: MECHANICAL Description of Work: INSTALL HEAT PUMP AND REPLACE AIR HANDLER. ADD CMA(CARBON MONOXIDE ALARM) NEAR BEDROOMS DUCT TEST REQUIRED. Sq. Ft. per floor: First Heat Type(Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor Fees MECHANICAL BLACK HILLS, INC $ 29.50 TOTAL FEES: $ 29.50 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 in the State of,Washington. Si nature , �° Date �� - 1�`� � Date: Firm � �/� �ll��,:L By� � YELM COMMUNiTY SCHOOOL. -SUPPORT OpERA'fION CENTE62 BUS MAINTENANCE FACILITY-HAZARDOUS MA7ERIAL INVENTORY TOM# pESCRIPTIC3N �� T ni innr�riTv 0'f 010 Union Guardrail 15/40 01020 Chevron 10140 09025 75-050 5W-30 SAE(Napa) �;} n� �ra�m ; 09030 Union Guardaii 5/30 i l U 1� iii ; 01040 34W Chevron 40 (36 ) 458-$402 �Oa43 75-130 90W-30 Napa ; 01045 75-110 3W Napa REC#: 001247Q7 4/11/2U�3 11:33 AM 01046 370 Dextron VI(Napa) OPER: CO TERM: 001 i 09050 15W50 Mobil Synthetic(Napa REF#: 14052 01110 Dsxron NI AT�' ' 01113 9801 P/S Fluid Napa) TRRN: 33,ODUCi BUTLDING PEfiMITS 01194 Lube Guard 10 oz.tube "10130167 29.50CR 01115 Transynd ATF pon Small KAUTZMAN, JERRY ' 01'{24 75-207 Mercan 5 AFT 5ynih(Napa) 10438 BRIGHTON ST SE 01190 Hydra-Trac, Clark�ift MECH 29.50CR ! 0'[2Q0 85-805 h draulic oil AW46 Napaj 01203 85-905 AW 32 H draulic oil(Na a} l FNDEI2ED: 29.50 CHECK 09204 JD 20C H draufic oi1 APPL7E�: 29.50- ! 01205 85-475 Hydraulic oil 01295 FGR1G 75-9QW S n Gear oil CHANGE: � 0.00 ' 01220 8Q-140 Gear oil ' 0322� M28-32 Ani-Freeze&Rust Guard QT g at ; 01225 35-901 DO7 3 Brake Fluid Napa PT 2-6 gal 01250 9004999099 DEF 250 ga1 GAL 250 al 01300 Chassis grease GAL 30 gal (1l4 doz. ' 01505 FCA001 Fleetchar er Anti-freeze ext. life QT 55 al ' 01590 Anti-freeze 50150,green QT 55 al 01520 Anti-freeze 50/50, Full Strength green QT 6 gal 01524 SE96 Seafoam Diesel/Gas motar trtm p� 2 at 09525 20-16-051 REcon Lift oil PT 1 ga1 Shop Supplies 19999 4058 Napa Kool Napa windshield washer winter solution#305 GAL 6 gal Windshield wiper ancentrate- United#914 GAL 6 gal ' ' Fleet-Zyme bus was soap#162 GAL 55 al 8rake parts cleaner GAL 30 gal ; Current Waste Praduct Storage Containers Coalant'f 90 Galfon Oii- 275 Galfon-5 drums on coasters ' 2 ea Cleanin #anks on 1/4 drums ' 9 ea Brake cieanin tank on roAing sfand 1 ea Carb. Cleaner on 1/4 drum BU5 MAINTENANCE FACIl.I7Y-FLEET FUELWG STATION 20,004 GALL.ON ABOVE GROUND TANK 0656'1 Unfeaded Gasoline GAL 90,000 gal 06562 Diesel Fuel GAI. 10000 gal SPILL RESPC?NS�POLECY EXNIBIT A I FROM black hills (THU�RPR ll 2073 7:35/ST_ 7:35/No.T500000398 P l z� [�V6�1 CI'i'Y OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM Project Address ��rt�Jg i✓� Il� t,�0►'1�t' Parcel#: �Q�JD�(.�j0 g�� Subdivision: Lot#: Pfan#: Zoning: • ❑ New Construction 0 Re-Model/Re-Roof/Addition 0 Home Occupation Sign ❑ PMumbing �Mechanicaf ❑ Mobile/Manufactured Home Placement ❑ Other Project DescriptionlScope of Wor1c: S �i.- (�, � ��r p� _%C - � , � '.t ��'lr .., r' . � ,`-ti�, , .�l/``� r., ..�lt,- ( �.. - Project Value: �- - ' = :>c L' ' "j r=.�"T lC� ��'ui l'E cE Building Area{sq.ft} 1°`Ftoor 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? lfyes, a completed environmental checklist must accompany permit application. , Q 2-i�rtA.Y1 ADORESS_[��34 P�r�h. r� 4-� EMAIL CITY ST E W� ZIP �b 4i`S�f TELEPHONE �bta63 -'Z53-(�37 7 „ LICENSE# ADDRESS �EMAIL CITY STATE ZIP TELEPHONE TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S I.ICENSE# EXP DATE CITY LICENSE# .,, �.., TELEPHONE ADDRESS EMAIL CITY $TATE ZIP FAX CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE# 4L L S C, TELEPHONE 3LeL�-f?(�-Q-~r��ip ADDRESS � EMAIL CITY STATE U3R- ZIP_�;p 1 FAX CONTRA T R'S LICENSE#Q�L�Y��7-�ip(��EXP DATE7 ITY LICENSE# 'C�CX,�3 �Q.U Copy of mitigation agreement with Yelm Community Schoals, if applicable. I hereby certify that the above information is corract and that the construction on,and tha occupanty and the use of the above described property will be in accordance with the laws,rules and reyulations of the State of Washington and the City of elm. � �l Appl�cant's Signature Date Owner/Contractor 1 Owner's Agent/Contractor's Agent(Please circle ane.) All pe�mits are non-transferable and will expi�e if work authorized by such permit is not begun within 180 days of issuance,or if work is s p,enc�e qr,�b�doned for a period of 180 days �i��`J Y 6�,?�*.' EL.4 � ��,1,.� _..� . .. �.__ 105 Yelm Auenue Weat (360)438-38 �c EIVED Yelm,WA 88597 (360)458-31 rvww.ci.yelra.rua.us APR 11 2013 BY: _ CITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM ProjectAddress �L�� 1��,�1�1"��j � Parcel#: �rt7C � C�°(:�1�T.>��`�` Subdivision: Lot#: Plan#: Zoning: � New Construction � Re-Model/Re-Roof/Addition u Home Occupation Sign ❑ Plumbing �Mechanical �I Mobile/ Manufactured Home Placement � Other Project Description/Scope of Work: L� tS��.�.s� ��LL(�� C��,�t)1.ij � K � ��(�L,.i, �:,��IlC��1��,(��'`� Project Value: Building Area(sq. ft) 1 St 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? If yes, a completed environmental checklist must accompany permit application. ��„��Q��: .�. .jl �L�.l Z;'V'lL2f 1 ADDRESS ' � , ►�1 c�� S F EMAIL CITY L �,�� ST E L�� ZIP �`�11' TELEPHONE �k;:�� ~'�15.3-L';31% �R�FI�C"�' ;;,, ��;�R LICENSE# ADDRESS EMAIL CITY STATE ZIP TELEPHONE C�I�IERAL.��t'TI�A�T�3R TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE# �![.U[U1B[hl� ,�'T�3R TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE# I1��CH�II�AL'CONTRACTf3R (:��I� l ��S ltvtL TELEPHONE ?�:�. ; tCt>.�S�sc'�L� ADDRESS�,.+"� tl��-�. EMAIL CITY 1 �� STATE lA=f� ZIP t�i�s;c.,1 FAX CONTRA TOR'S LICENSE#I�l�kCkl�ZC?lclrk EXP DAT�I ` ITY LICENSE#(% i �l_•�'�t°•�'�5�.(� Copy of mitigation agreement with Yelm Communiry Schools, if applicable. I 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�elm. ��'j�,��*>�1 ��I ��Y� ��'?'1`Y�l �- � � � Applica ' n re Date 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 Avenue West (360)458-3835 Yelm,WA 98597 (360)458-3144 FAX www.ci.yelm.wa.us � �� j� �� _ �� " ; % �� .�r�� 7 � � j >`�r=�<z�.� �` �. f � � F , / 0 i '� � � � Duct L�akage Tes# ResuPts (Existing Construction) Permit#: � ��,� ��' 1(l' ' � / �� % _ House address or Eot number: ( �� t) ''�"� (�{'�(�/'} � � `� � ,1 City: � '�L.��"),.i Zip: ��b`J��`� � Cond. Floor Area (ft�): t "-� �`T ❑ Duct tightness testing is not requir�d for this r�sidence per exceptions Eisted at the end of this document Test Resutt:_��CFM@25Pa _, I Ring {circle one): Open 1 2 3� Duct Tester Location: �� Pressure Tap LocatFan: /��,. ��C�� Campany Name: ��2 c��,'�/�.� ,�-it L Duct Testing Technician: _�(� � /�� `� � TecF�nician Signature: L!' Date: y�Z� ' � 3 r Phone Number: ��o �' �U� -- ��1 �3 Washington State Energy Code reference: ?o+ '� ?�Mechartical Systems:Those parts o#systems which are altered ar rep�aced shaH comply with Section 503 of this Code ,,3.,... when a spaee-conditioning system is aitered by the installation or replacement of space-conditioning equipmenf (inGuding replac�ment of itie air handier,oufdoor condensing unit of a spiit system air corxiitioner or heat p�np, cooiing or heafing cail,or the fumace heat excfianger),the duct systam that is conneeted to the new or replacemertt space-canditioning equipmer►t sfia11 be seaied,as confirmed through fiefd verification and diagnos6c testing in accordance with procedures for duci sealing of existing duct systems as specified in the RS-33,to one of the foilowing requirements. Exceptions: 1. Duct systems that are documenied to have been previously sealed as confirmed through field verification and diagnostic testing in accordanc�with procedures in RS-33. 2. D�ts with less than 40 lir�ar#e2t in uncondltioned space�. 3. Existing duct syste�ns constructed,insufated or sealed�vitn asbestos