20140127 Permit Pkg 02272014 'f''oF ''"�� City of Yelm Permit ►vo.: 20140127
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� � Community Development Department Issue Date: 2/27/2014
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
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'"."»'"°'°" Fax: (360)458-3144 '
Applicant:
Name: HARDING GREENS Phone:
Address: P.O. BOX 71
YELM WA 98597
Property Information:
site Address: 107 WASHINGTON AVE SW Owner: HARDING GREENS
Assessor Parcel No.: 75301600700 Subdivision: Lot:
Contractor Information:
Name: WASHINGTON ENERGY SERVICE Phone: 206.282.4700
Address:
2800 THORNDYKE AVE.W
SEATTLE WA 98199
Contractor License No.: WASHIES9710B Expires: 4/02/2005
Project Information;
Project: MECHANICAL
Description of Work: REPLACE 100K GAS FURNACE
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
MECHANICAL WASHINGTON ENERGY SERVICE $ 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 W shingto .
Signature Date � Q� Date:
Firm BY�
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OPER; 3712
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T�'AN: �3
201�1�,7 Q� BUILDrNG
ro R�rNG GRE�NS 29,��R rTs
MECH WASHINGTON AV
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TFND�RfC1� 29.SOCR
APP(IED; � 29.5Q
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CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 107 WASHINGTON AVE SW Parcel#: 75301600700
Subdivision: Lot#: Zoning;
❑ New Construction � Re-Model/Re-Roof/Addition ❑ Home Occupation Sign
❑ Plumbing ,�Mechanical ❑ Mobile/Manufactured Home Placement ❑ Other
Project�escription�scope ot'work: REPLACE 100K GAS FURNACE
Project Value:
Building Area(sq. ft) 1S'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 apptication.
BUILDING OWNER NAME: �oHrv HaROtNc
ADDRESS�07 WASHINGTON AVE SW EMAIL
CITY YELM STATE WA ZIP 98597 TELEPHONE ssa�so-ssos
ARCHITECTlENGINEER LICENSE#
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR washington Energy Services TELEPHONE 800-398-4663
ADDRESS 3909 196th St SW EMAIL
C��'�( Lynnwood STATE wA ZIp �o� FAX
CONTRACTOR'S LICENSE# wASHiESS��oe EXP DATEsns CITY LICENSE# 30501
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY 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.
. . �C��i!lil,L�� 7/ � ���
Applicant's Signature --� Date �
Owner/Contractor/Owner's Agent/ ontractor's Agen 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
���IVED
FEB 2 6 2014
105 Yelm Auenue West (360) 35
PO Box 479 (360) '
Yelm,WA 98597 www.ciyedm.wa.us