20140168 Permit Pkg 05132014 �oF TH�p,� City of Yelm Permit No.: 20140168
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� *� Community Development Department Issue Date: 5/13/2014
a � (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
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'"""'"°_°" Fax: (360)458-3144
Applicant:
Name: MICHAEL/SHARON THOMAS Phone: 360-960-8620
Address: 10029 COCHRANE AVE SE
YELM WA 98597
Property Information:
site Address: 10029 COCHRANE AVE SE Owner: MICHAEL THOMAS
Assessor Parcel No.: 56510001400 Subdivision: JOHN'S MEADOWS Lot: 14
Contractor Information:
Name: BRENNAN HEATING Phone:
Address:
4601 S 134TH PL
SEATTLE WA 98168
Contractor License No.: BRENNHA971R4 Expires: 12/29/2013
Project Information:
Project: MECHANICAL
Description of Work: INSTALL DUCTLESS HEAT PUMP
Sq. Ft. per floor: Heat Type(Electric,Gas, Other):
First
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
MECHANICAL BRENNAN HEATING $ 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 ashington.
��,'2 �r7���� Date:
Signature Date v �-�
Firm
�E N � � �� BY:
Git� a���lmo�
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REC#: 001606TERM: Op1��2014 11:13 AM
OPER: CQ
REF#: 40ti13
7RAN: 33a���� BUILDI29 50CR�TS
20140168
THOMAS, MICHAEUSHARON
10029 COCHRANE ��E,�OCR
M'ECH
TENaERED: 29.5� CHECK
APPLIED: 29.50—
CHANGE: 0.00
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CITY OF YELM
RESIDENTIAL BUILDING PERMI APPLICATION FORM
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Project Address:���� �,���_�r t;�y\�, arcel#:
Subdivision: Lot#: Plan#: Zoning:
❑ New Construction ❑ Re-Modei/Re-Roof/Addition � Home Occupation Sign
o Piumbing �echanical ❑ Mobile!Manufactured Home P�acement � Other
Project Description/Scope of Work:�� �� �� � a.1-� � �� ��J����
�- �
Project Value: �� ��
Building Area(sq.ft) 1$`Floor 2ntl 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?
Ifyes,a completed environmental checklist must accompany permit application.
BUILDlNG O ER NAME: ' � (�-� � ��, � � �
AQDRESS (2 EMAIL
C�n' STATE ZIP TELEPHONE - � � • '�.-
ARCHITECTlENGINEER LICENSE#
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERALCONTRACTOR TELEPNONE
ADDRESS EMAIL
C�T�' STATE ZIP FAX
CONTRACTOR'S IICENSE# EXP DATE____CITY LICENSE#
PLUMBING GONTRACTOR TELEPHONE
ADDRESS EMAIL
C��' STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE ClTY LfCENSE#
MECHANICA CONTRAGTOR � PHONE=� ` ` Q
, ,,
CIIY`�SS C� , � EMAIL� r7..; R.�1I'� �'-�'�
' STAT �CL ZI 1'� �, FAX: .
CONTRACTOR'S I.ICENSE# EX DATE ITY CENSE#
9 ��� � � , i .
Copy of mitigation a reement it �(elm ommuni � oo�s, f applicab�e.
I he certlfy that the above Information is correct and that the eonstruction on,and the occupancy and the use of the
�ve d cribed property wi11 be in accordance wlth the laws,rules and regulatlons of the State of WashingtOn a�d the
Gity of Y m.
`J� �
li ant's Signature Date
et'1 Contl'BCtOr/Owner's Agent I 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
205 Yelm Avenue West
Yelm,WA 98597 (360)458-3835
wcow.ci.yelm.raa.us (360)458-3144 FAX
Karen Bennett
From: Jaimie How[jaimie@brennanheating.com]
Sent: Thursday, May 08, 2014 10:01 AM
To: Karen Bennett
Subject: Mechanical Application
Attachments: mthomasmechapp.pdf
Importance: High
Please find attached mechanical application for a ductless heat pump install. Please let me know the fee due once
processed and ready for pick up.
Thank you,
Jaimi.e 3-�otiv
Permit Coordinator
Brennan Heating and Air
206.248.7900 office
877.273.6626 (toll free)
206.248.7905 fax
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