20140146 Permit Pkg 04072014 �o� rHEp��' City of Yelm Permit No.:
20140146
� � Community Development Department Issue Date: 4/07/2014
Building Division (Work must be completed within 180 days)
Phone: (360)458-8407
LM
w."`����",°" Fax: (360)458-3144
Applicant:
Name: SIERRA MURPHY
Address: 207 MOSMAN AVE SE Phone: 360-458-7843
YELM WA 98597
Property Information:
Site Address: 207 MOSMAN AVE SE Owner: SIERRA MURPHY
Assessor Parcel No.: 22719331700 Subdivision:
Lot:
Contractor Information:
Name: SIERRA MURPHY
Address: Phone:
207 MOSMAN AVE SE
, YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: MECHANICAL
Description of Work: SINGLE ZONE DUCTLESS HEAT PUMP SYSTEM
Sq. Ft. per floor: Heat T
First ype(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor
MECHANICAL SIERRA MURPHY Fees
$ 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 nd correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regu ti ns including those overning zoning and land subdivision,and in addition, all covenants, #Sets of Prints:
easement es �ctions of ord. If applying as a contractor, I further certify that I am currently
registered in t e of as i to Final Inspection:
Signature r Date Date:____
Firm By.
Cit� of Y�lm
(36 } 458-8402
*���� REPRINT RECEIPT*�*�*
REC#: 00157478 4/09/2014 3:23 PM
OPER: CO TERM: 001
REF#: 2831B
TRAN: 33.0000 BUILDING PERMITS
20140146 29.50CR
MURPHY, SIERRA
207 MOSMAN AVE SE
MECH 29.50CR
TRAN: 30.0000 BUSINESS LICENSE
NARROWS HEATING & AC
BUSINESS LICENSES & 35.00CR
TENDERED: 64.50 CHECK
APPLIED� b4.50-
CHANGE: 0,00
: �
. � � '�� 4. � � - , . . .
}
owaF ''HFA�,�� City of Yelm Permit No.: 20140146
� � Community Development Department Fee Calculation Worksheet
Building Division
Phone:(360)458-8407
L
Fax:(360)458-3144
Applicant:
Name: SIERRA MURPHY Phone: 360-458-7843
Address: 207 MOSMAN AVE SE
YELM WA 98597
Property Information:
site Address: 207 MOSMAN AVE SE owner:
SIERRA MURPHY
Assessor Parcel No.: 22719331700 Subdivision: Lot:
Project Information:
Project: MECHANICAL
Description of Work: SINGLE ZONE DUCTLESS HEAT PUMP SYSTEM
Sq.Ft.per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Units Fees
MECHANICAL PERMIT 1 $ 20.00
WHOLE HOUSE FAN/MISCELLANEOUS 1 $ 9.50
TOTAL FEES: $ 29.50
PAYMENTS MADE: $ 0.00
BALANCE DUE: $ 29.50
'o201� C� 1� �o
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address:_G�� ���ISI�J��J 1�'?I� S�f� Parcel#: �Z�1��� %��
Zoning; Current Use: Proposed Use:
❑ New Construction � Re-Model/Re-Roof/Tenant Improvement
0 Plumbing b�llechanical ❑ Fire PrevenUSuppress/Alarm [I Other
,f �
Project Description/Scope of Work: - i- � (G �� ,S ���
Project Value:_�tp, 3�1 � J
Building Area(sq. ft) Parking Garage 1S`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 OWNEWTENANT NAME: S � 's . ,
.� -
ADDRESS 2-��= - 1 �'�Nll r�;� �''� � EMAIL
CITY L STATE 1�;� ZIP TELEPHONE ?� (_',
ARCHITECT/ENGINEER LICENSE#
AQDRESS EMAIL
C��' STATE ZIP TELEPHONE
GENERAL CON?RACTOR . TELEPHONE
ADDRESS EMAfL
CITI' STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE_CITY LICENSE#
PLUMBING CONTRACTC?R TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
MECHANICAL CONTRA TOR TELEPHONE - � ' �
ADDRESS � M EMAIL
GTY—T7�t_ STATE ZIP ��;yc�`j FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
Copy of City Mitigation documentation(TFC).
I hereby certify that th }ov i formation is correct and that the construction on,and the occupancy and the use of the
above described pro e ilt be i accordance with the laws,rules and regulations of the State of Washington and the
City of Yelm.
ApplicanY Sig ure D e
Owner/Co ctor/Owner's Agent I Contractor's Agent/Tenant (PI ase 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 18Q days
�C�����
��-V�-�Il�(t.l(�OUI'��-`�-17 . C�� A PR 0 3 2014 i
I05 Yelm Auen�te West � � — �
PO Box 479 ( 8-3835
Yebn, WA 98597 www.ci.yelm..wa.us
Page 1 of 1
Steve Calhoun
From: Karen Bennett[KarenB@ci.yelm.wa.usj � � ����� �� � � �
Sent: Monday, April 07, 2014 11:35 AM
To: Steve Calhoun
Subject: City of Yelm Mechanical Permit Fee Sheet-207 Mosman Ave SE
� Attachments: 20140146 207 Mosman Ave SE.pdf
�
�lez�Steve, yot the��errnit done,for yvu. So the p�rmit is running you $2y.5o and your
f�t�siness licertse is ��3,�.vo
Y�ur� tatal will h y��4.�0
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It's avaitable for iJou to piek up at an�r tirne.
Karert 7�: BE�nn�etf
Cttl� Of YPI772
zo�5 Yel�n Avc� W
Y�;lrn, T�t'A �8597
� (360)45�-3�3
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