20140151 Permit Pkg 04152014 o� TH�p� City of Yelm Permit No.: 20140151
� ,
� �'� Community Development Department Issue Date: 4/15/2014
a n► (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
ELM
'»c=°" Fax: (360)458-3144
Applicant:
Name: RYAN & KARIE MENDELL Phone: 360-870-5194
Address: 10005 JENSEN DR SE
YELM WA 98597
Property Information:
site Address: 10005 JENSEN DR SE Owner: RYAN MENDELL _
Assessor Parcel No.: 78640103300 Subdivision: TAHOMA TERRA Lot: 33
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: AC UNIT ADD ON
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
MECHANICAL BIGFOOT HEATING $ 29.50
TOTAL FEES: $ 29.50
Applicant's 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 Washington.
� / /T- Date:
Signature � Date (�'s' ([.�
By:
Firm
Cit� of Y�lm
(36 } 458-ti4G2
REC#; 001581U1 4f15J2014 9:19 AM
OPER: CO TEkM: 001
REF#: 3332
TRAN: 33,(�000 BUTLDING PERMITS
2n140151 29.5Q�R
MENDELL, RYAN & KARIE
100Q5 JEN5EN DR SE
MECW 29.50CR
TENDERED: 29.50 CHECK
APPL1'ED: 29,50-
CHANGE: 0,00
�SI
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: �v�us �.v�S�z 1.��' ��Parcel#']�.�,�'-iv���3 d0
Subdivision: 1G1�,�,,� Lot#: Plan#: Zoning:
New Construction ' Re-Model/Re-Roof/Addition Home Occupation Sign
' Plumbing ;r�Mechanical Mobile/Manufactured Home Placement Other
Project Description/Scope of Work: �I �.�- ��� � ✓�
Project Value:
Building Area(sq. ft) 1S` Floor 2"d Floor Garage Deck
Basement Carport Patio
#Bedrooms_ #Bathrooms_ Heating: GAS/OTH or ELECTRIC(Circle One)
Are there any environmentally sensitive areas located on the parcel?
lf yes, a completed environmental checklist must accompany permit application.
� BUILDING OWNER NAME: �.�
ADDRESS �S � t EMAIL
GTY STATE1,Jc, ZIP�'� TELEPHONE'3(� 2�v (o� 1
ARCHITECT/ENGINEER LICENSE#
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERALCONTRACTOR 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#
Ji6 MECHANICAL CONTRACTOR �: '' TELEPHONE LI S"� ��1;,�
ADDRESS o Z- �Z- S EMAIL
CITY �.,(,,� STATE ZIP ' FAX
CONTRACTOR'S LICENSE# EXP DATE� ' ITY LICENSE#1 3'�J�2 7 � v
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 descri ed property will be in accordance with the laws,rules and regulations of the State of Washington and the
City of Yel
`�� � �s� 1�1
Ap icant' Si "n ture Date
O ner/Cont ctor I Owner's Agent/Contractor's Agent(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
� 105 Yelm Avenue West (360)458-3835
Yelm,WA 98597 (360)458-3144 FAX
www.ci.yelm.w¢.us