20140154 Permit Pkg 05022014 0 0� T"�a,��. City of Yelm Permit No.: 20140154
� � Community Development Department Issue Date: 5/02/2014
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
YELM
'"�""'"`�"'" Fax: (360)458-3144
Applicant:
Name: AMERICOOL HEATING Phone: 360-273-3300
Address: 17929 IRWIN RD SW
ROCHESTER WA 98579
Property Information:
Site Address: 9206 CARYS ST SE Owner: THOMAS A WILSON
Assessor Parcel No.: 63520004300 Subdivision: MT SHADOW Lot: 43 '
Contractor Information:
Name: AMERICOOL HEATING Phone:
Address:
17929 IRWIN RD SW
ROCHESTER WA 98579
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: MECHANICAL
Description of Work: INSTALL HEAT PUMP
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other): HEAT PUMP
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
MECHANICAL AMERICOOL HEATING $ 29.50
TOTAL FEES: $ 29.50
Applicant's Affidavit:
I certify that I have read and examined the information contained within the application and know the same OFFICIAL USE ONLY
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 urrently Final Inspection:
registered e S ate of Washington.
Signa re Date Date:
Firm By�
Cit� af Y�lm
(36 ) 458-8402
REC#; 00159390 5/02/2014 10:33 AM
OPER: CO TERM: 001
REF#: 7185
TRAN: 33.0000 BUILDT2� 50CRITS
� 20140154
AMERICOOL HEATING
9206 CARYS ST SE
MECH 29.50CR
TENDERED: 29.50 CHECK
APPLIED: 29.50-
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CITY OF YELM
RESiD�NT1AL BUILDING PERMIT APPI.�CATION FORM
Project Address: ���b �I,�-�� �� s� Parcel#: � �S2o�7U ��00
Subdivision: Lot#: `�3 Plan�`: Zoning: ' �������
❑ New ConstrucGon r� Re-Model/ Re-Roof/Addition o Home Occupation Sign
❑ Plumbing -�MechanicaE ❑ Mobile/Manufa�tured Home Placement � Other
Projec#Description/Scope of Work: ►��r��1n�� ��.1�"7 (�lIM�
Project Value: � � Z��'bD
Building Area(sq.ft) 1 et Floor 2"d Floor 3`d Floor Garage-2 car�3 car
Covered Patio Covered Porch Patio Deck
# Bedrooms_ # Bathrooms_ Heating: GAS/OTHER or ELECTRIC (Circls One)
Are there any environmentally sensitive areas located on the parcel? N�
!f yes, a completed environmental checklist must accompany per'mit applicetion.
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CITY �{°!E� STATE ZIP � 7 FA?C 2.0 � � � �
CONTRACTOR'8 LICENSE#��SU EXP DATEa� CITY LICENSE# 1 � 1;� v �2y 0
Copy of mitigation agreement with Yelm Community Schools, if appfic�ble.
1 hereby �fy th t the above infvrma#ion is correct and Lhat the construetlon on,an8 ihe occupancy and the uss of the
above d cribed roperty � in accordance with the laws,rule9 and regulatiorts o#the State af Washington�nd thA
CltylOf Im. ���
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Ap li ant's ' re Date
Ow r ontractor Owner's Agent/contractor's Agent(Please circle one.)
All permits are non-transferable and will expire if work authorized by such perrrei�t is nat begun
within 1 s0 days art issuan�ce, or If work Is suspended or abandoned#or a perlod of 180 days
!06 Yelm Avenue West (36D} 455-3835
Yel�ra, WA 98a97 (360)458-3I4�Ft1�Y
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Roc,�cster,WA 98579
(3bQ)273-3300 or(3�6U) 748-6169
(360)273-333���c
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