20130252 Permit Pkg 06252013 o� City of Yelm Permit No.: 20130252
Community Development Department Issue Date: 6/25/2013
� (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
"`" '°" Fax: (360)458-3144
Applicant:
Name: WENDY BALDWIN Phone: 360-458-3253
Address: 1019 KINGSVIEW CT NW
YELM WA 98597
Property Information:
site Address: 1019 KINGSVIEW CT NW Owner: WENDY BALDWIN
Assessor Parcel No.: Subdivision: Lot:
Contractor Information:
Name: BIGFOOT HEATING Phone:
Address:
14510 123RD AVE SE
YELM WA 98597
Contractor License No.: BIGFOHA891J9 Expires: 4/01/2013
Project Information:
Project: MECHANICAL
Description of Work: REPLACE FURNACE
Sq. Ft. per floor: First Heat Type(Electric,Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
MECHANICAL BIGFOOT HEATING $ 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 re rictions of record. If applying as a contractor, I further certify that I am currently Final Inspection:
registered in the a e o ash� gton.
� Date:
Signature Date
, gy:
Firm
Cit� of Yelm
�36 ) 458-8402
REC#: 00131340 6/,�5/2013
� OPER: CD TEaM: 001 3:39 PM
REF#: M�
r�A�: 33.00OU BUILDING PERMITS
20130152
BALDWIN, WENDY��'50CR
�01g KINGSVIEW CT NW
MECH 29.50CR
TENDERE�:
ApPLIEQ; �9•50 OTHER
29.50-
CHANGE; �"-'�" ---
0.00
CITY OF YELM �'/ ���"
RESIDENTIAL BUILDING PERMIT APPLICATION FORM �
Project Address: ��\��-��-.�;.��� c_�1�� Parce�#: 57 L 3��D�7�v
Subdivision: Lot#: Plan#: Zoning:
❑ New Construction ❑ Re-Model/Re-Roof/Addition ❑ Home Occupation Sign
❑ Plumbing �f Mechanical ❑ Mobile/Manufactured Home Placement ❑ Other
Project Description/Scope of Work: _��\�c..� �v�Yr�C.�
�`�
Project Value:
Building Area(sq.ft) 1 g'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.
BUILDING OWNER NAME: � c,, �. cLw�.�
ADDRESS �\ ' � � ` � EMAIL
CITY `/a�l!--` ST E�,.l�ZIP��551 TELEPHONE � �
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 ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
MECHANICAL CONTRACTOR ` � TELEPHONE i-14�;, �(.,l., �,
ADDRESS 13 2 EMAIL
CITY �(�1 ,,,� STATE�y_ZIP`i� 11 FAX
CONTRACTOR'S LICENSE#' � � — EXP DATE�CITY UCENSE#
Copy of mitigation agreement with Yelm Community Schools, if applicable.
I hereby ceRify 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 Yel
� s/ � 'Z� ��
A licant's Sig ature 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
]05 Yelm Avenue West (360)458-3835
Yelm,WA 98597 (360)458-3144 FAX
www.ci.yelm.wa.us