20130358 Permit Pkg 11202013 "f'�oF T"�p„�'�" City of Yelm Permit No.: 20130358
7
� � Community Development Department Issue Date: 11/20/2013
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
EL
"".""'""°" Fax: (360)458-3144
Applicant:
Name: YELM LIONS Phone:
Address:
Property Information:
Site Address: 301 YELM AVE W Owner: YELM LION CLUB
Assessor Parcel No.: 75300900800 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,Ga , Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
MECHANICAL BIGFOOT HEATING $ 25.00
TOTAL FEES: $ 25.00
ApplicanYs Affidavit: OFFICIAL USE ONLY
I ceRify 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 res,trictions of record. If applying as a contractor, I further certify that I am currently
registered in the St'dte of ashington. Final Inspection:
Signature ` �� ���� Date ?�, Date:
Firm � Y� �^ _ �� . By�
J
Cit� of Y��m
(36 � 458-8402
�E(,#: 00144849 11j20/2013 10.08 AM
OF'ER: GO TERM: 001
REF#: MC
TRAN: 33.OQ00 BUTLDING PERMITS
20130358 25.00CR
YELM LIONS
301 YELM AUE W
MECH �5.00CR
TENDERED: 25.00 OTHER
APpLIED: 25.00-
CHANGE: 0.00
' Zot3 n35�
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address:3�1 `��1 i�, �,��a�C'� Parcel #: �5��:)���°,cv t�
� Zoning; Current Use: Proposed Use:
❑ New Construction ❑ Re-Model/ Re-Roof/Tenant Improvement
❑ Plumbing �' Mechanical ❑ Fire PrevenUSuppress/Alarm ❑ Other
Project Description/Scope of Work:`���,'�5;,c�r� ��„��c=� �-
1
Project Value:
Building Area (sq. ft) Parking Garage 1St Floor 2"d Floor 3�d Floor
Building Height
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER/TENANT NAME: � L 3 ,,�
ADDRESS "'�` " EMAIL � ��� �t �:,;� ,��
CITY STATEy,�ZIP �.� t -1 TELEPH NE
ARCHITECT/ENGINEER LICENSE#
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR 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 + � � � �ELEPHON ' ' ,�"y � �'.
ADDRESS i 2 • � ° MAIL h s ' � ���
CITY 4SL1.� STATE ... ZIP ��`� 1 FAX
CONTRACTOR'S LICENSE# "' '^ ^ EXP DAT CITY LICENSE# 13 -�s�� ��.� ,0
Copy of City Mitigation documentation(TFC).
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.
��—� \ ^ `�
A licant's Si ture Date
Owner I Contr ctor I Owner's Agent/Contractor's Agent/Tenant (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
(360)458-3835
105 Yelm Ave W (360)458-3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us