20130198 Permit Pkg 05212013 o� City of Yelm Permit No.: 20130198
� Community Development Department issue Date: 5/21/2013
�
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
"' °" Fax: (360)458-3144
Applicant:
Name: ROBERT& ROBIN LEE Phone:
Address: 10806 UMTANUM ST SE
YELM WA 98597
Property Information:
Site Address: 10806 UMTANUM ST SE Owner: ROBERT LEE
Assessor Parcel No.: 32640001800 Subdivision: Lot:
Contractor Information:
Name: CAPITAL HEATING AND COOLING Phone:
Address:
1218 CARPENTER RD
LACEY WA 98503
Contractor License No.: CAPITHC948N3 Expires: 9/08/2013
Project Information:
Project: PLUMBING
Description of Work: ADD AIR CONDITIONER TO EXISTING GAS FURNACE
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
MECHANICAL CAPITAL HEATING AND COOLING $ 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 Washingt .
Signature �� Date Date:
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Cit� af Y�)m
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I.EE, RQ�ERi � ROBIN
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___.____.___.__ __.__
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CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
ProjeCt Address:�osos umtanum st sE Parcel#:3zsa000�eoo
Subdivision: Lot#: Plan#: Zoning:
New Construction ✓ Re-Model/Re-Roof/Addition l Home Occupation Sign
Plumbing �Vlechanica - Mobile/Manufactured Home Placement � Other
Project Description/Scope of Work:
Add air conditioner to existing gas fumace
Project Value:�200
Building Area (sq.ft) 15t Floor 2"d Floor Garage Deck
Basement Carport Patio
#Bedrooms_. #Bathrooms_ Heating: GASIOTHER 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 UWNER NAME:Robert�ee
ADDRESS�oso6 umtanum st sE EMAIL
CITY Ye�m STATE"`�A ZIP g8597 TELEPHONE 3so-aoatssz
ARCHITECT/ENGINEER LICENSE#
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERALCONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE_CITY LICENSE#
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE Z�P EXP DATE CITY LICENSE#
CONTRACTOR'S LICENSE#
MECHANICAL CONTRACTOR capita�Heating and coo�iog TELEPHONE 3so-sa5-z�a7
ADDRESS�Z�8CarpenterRd EMAIL W��IiamQnwpermit.com
CITY�acey STATE WA ZIP 95503 FAX
CONTRACTOR�S LICENSE#CAPITHC948N3 EXP DATE09108�t3CITY LICENSE#
Copy of mitigation agreement with Yelm Community 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 of Yelm.
05t1412013
Applicant's Signature Date
Owner/Contractor I Own 's A nt Contractor's A lease 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