20130297 Permit Pkg 08202013 ��F TH�p� City of Yelm Permit ►vo.: 20130297
4 Community Development Department Issue Date: 8/20/2013
s�, (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
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"'"`"'""°" Fax: (360)458-3144
Applicant:
Name: ADAM/AMANDA EATON Phone: 360-970-6936
Address: 520#1 LILLY DR
FT WAINWRIGHT AK 99703
Property Information:
Site Address: 15767 104TH AVE SE Owner: ADAM EATON
Assessor Parcel No.: 85840007200 Subdivision: YELM TERRA Lot: 72
Contractor Information:
Name: PRATTS PLUMBING Phone:
Address: PAMELA PRATT
3301 46TH AVE NE
OLYMPIA WA 98506
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: PLUMBING
Description of Work: Water Heater Replacement
Sq. Ft. per floor: First Heat Type(Electric,Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
PLUMBING PRATTS PLUMBING $ 27.00
TOTAL FEES: E 27.00
ApplicanYs Affidavit: OFFICIAL USE ONLY
I certify that I have read and examined the infortnation 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:
registerecS-irrt State of ington.
Signature. .--�' , � � �
Date � 3 Date:
Firm r •11 ,L1`G Gl.v�� `(3"O By�
Cif� of Yel�
(36 ) 458 8402
REC#; 00136799 8/20/20r3
OPER: CO TERM: 001 2:17 PM
REF#: 6401
TRpN: �3.00d0 BUILDING PERMITS
20130297
EATON, ADAM/pMANDA�CR
15767 104TH AVE SE
PL
27.00CR
tENpERED;
APPLIED: 27.00 CHECK
?7.00-
CHANGE: �`—"`-------
0.00
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�' CITY OF Y�L.M
, " R Ip�NTIAL� ILt�iNG PERMIT APPLICATION FORM
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Pro)ect Address: � Parcel#:
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Subdlvision� �' t#: Zoning; �
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+_, NeW�Construction !;�Re-Model/Re-Roof/Additfon �; Home Occup tlon Sign
;.�'Plumbing �( ni i � MobUe/Manufactured Home Placerrasnt ;r Other
. � - � 1��
ProJea DescriptioMSco f VNork: ' w �- �� 1��
Projectva�ue� �� , �
8uilding Area(sq•ft) 1 lool' __ 2"�Floor Garage ', Deck
a en�:ent Carpor�_F'atio
#Beclrooms� tl�rovms� Heati �GAS OTHER or EL�CTRiC( ircie One)
Are there arry environme Ily�ensitive a as#ocated on the parcel7 �,�:, ; if yes, a
completed environmenta c ec�ilist muat campany permit eppllcation. ,
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� Copy of mitigati ag`'eement wi h Yelm Comrt�unity Schools,if applicable.
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Ail permits ara non•tt'i� r�ls and wi l expir+e If work authorized by such pemtit s not begun
within 160 days of lssu q ��or tt work s sugpended or abandoned for a pe�lod ot 180 days
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