20140185 Permit Pkg 06132014 "��o� r"�a,�� City of Yelm Permit No.: 20140185
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� � Community Development Department Issue Date: 6/13/2014
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
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"'�`"'""°" Fax: (360)458-3144
Applicant:
Name: PEDRO SERRANO Phone:
Address: 128 VIEW DR NW
YELM WA 98597
Property Information:
site Address: 128 VIEW DR NW Owner: PEDRO SERRANO
Assessor Parcel No.: 81620000100 Subdivision: Lot:
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: DUCT LEAKAGE TEST REQUIRED
Sq. Ft. per floor: First Heat Type (Electric,Gas, Other):
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 th_e State of Washington.
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Signature �r� ��-P-u-llt-�w i"TtJLtJ Date �O '/ � '2D�7- Date:
F��, f�R N N���J �1 ��-T��U� -�CC, By� �
Cit� af Y�lm
(36 ) 458-8402
REC#: OU163365 6/13/2014 1:05 PM
OPERr CG TERM: 001
REF#: 40741
�CRAN: 33.0000 BUILUING PERMITS
20140185 29.50CR
SERRAPdO, PEDRO
128 VIEW DR NW
MECH 29.50CR
TENDERED: 29,50 CHECK
APPLIED: 29,5p_
CHANGE: y pp p
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2�I �Ic� i �
CI7Y OF YE�M
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
ProjectAddress:l� [7 ,��I C.l.� � I�I�I� Parcel#_ �I �O�(bC� ���
Subdivision: Lot#: Plan#: Zoning:
❑ New Construction ❑ Re-Model!Re-Roof i Addition C� Home Ocxupation Sign
❑ Plumbing �itechanicai ❑ Mobile/Manufactured Home Plac ment o Other
Project DescriptioNScope of Work: 7
Project Value:�_�o!�
Building Area(sq.ft) 1�`Floor 2"`'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?
/f yes, a completed environmental checklist must accompany permit application.
_
BUILDtNG O NAME:
ADDRE S �� EMAI�
CITY �C. STATE.�_Z1P ELEPHONE � - (v
ARCHITECT/ENGINEER LICENSE#
ADDRESS EMAIL
ciTY STATE ZIP TELEPHONE
( GENERALCONTRACTOR TELEPHONE
� ADDRESS EMAIL
I CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LiCENSE#
PLUMBIHG CONTRACTUR TELEPHONE
ADDRESS EMAIL
C�N STATE ZtP FAX
CONTRACTOR'S UCENSE# EXP DATE CITY LICENSE#
MECHANICAL CONTRACTD LE HONE
° c.om
ADDR SS � L EMAIL•1 't-C. �
CITY .�. STATE ZI FAX
CONTRACTOR'S LICENSE � P DATE C TY LICENSE#
Copy of mitigation agreement with Yelm Commun� ols,if appiicable.
I rt�ty that the abova irrtormatlon is comect and that the construction on,and the cecupa�cy and the usa of the
alfove de ribed propeRy witl be tn accordance with the laws,rules and regulations of the Stafe of Washington and the
Gity of Yel .
� � — �
p!i nYs Si9nature Date
21'/C8tlt1'8Ct0�/OW11@�'S Agent 1 Contractor's Agent(Please circle one.)
All permits are non-transferable and will expire if work authoriz�d 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 Auenue West qNNEp (360}�58-3885
Yelm,WA 98597 (360)458-3144 FAX
www.ci.yelm.wa.us
JUN 0 5 2014