20140245 Permit Pkg 09092014 �8F TH�A�' City of Yelm Permit ►vo.: 20140245
� � Community Development Department Issue Date: 9f89f6000""" ��'/J�
d th (Work must be completed within 186 days)
Building Division
Phone: (360)458-8407
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"".""'"`_°" Fax: (360)458-3144
Applicant:
Name: WILLIAM CUMMINS Phone: 360-858-7474
Address: 17406 PRIVET CT SW
ROCHESTER WA 98579
Property Information:
site Address: 14908 100TH AVE SE Owner: BILL CUMMINS
Assessor Parcel No.: 78640014400 Subdivision: TAHOMA TERRA Lot: 144
Contractor Information:
Name: BOB'S HEATING&AIR Phone:
Address:
13633 NE 126TH PLACE#425
KIRKLAND WA 98034
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: MECHANICAL
Description of Work: LIKE FOR LIKE WATER GAS HEATER REPLACEMENT
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
� Second
Third
Garage
Basement
Fees:
Item Contractor Fees
MECHANICAL BOB'S HEATING&AIR $ 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 Sta e of shington. � /
'�N�� �/���`1 Date:
Signature � ���i Date
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F��, ��s 1+�`t-,�.,,, �„� ,�� �,,,�!-�-,,�-,� y
Cit� af Y�lm
(36 ) 458-84Q2
REC#: 00171414 9/U9I2014 11:35 AM
OPER: CO TERM: 001
REF#; 5q4776
TRAN: 33.0000 �u��-�I29 50CRI�S
20140245
CUMMINS, WILLIHM
14908 100TH AVE2g�5aCR
MECH
TENDEREq: 29,50 CHECK
APPLTED: 29.5C1-
CHANGE: 0.00
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CIT1f GF Y�LM
RESIDENTIAL BUtLDING PERMIT APP'LtCATION FGRM
PrOJeCt/WdfA�e: 14808 1 DOth Ave SE P��#: 78640014440
9ubdlvlslon: _ Lot#: Plen#: Zoninp:
n New Consm,cUon l7 RB-Model/Re-Raof/Additbn ❑ Home OocupaBnn Slgn
❑ Plumbinp o Mechanlaal ❑ Mablle/Manufa�tured Home Ple�ment ❑ Other
prvject Da�piptlon/Scvpe of Wark: ��ke for Ilke water eas heater replaaement
ProJecl Velue: 1300.00
Buflding Area(sq.it) 9n Floor 2n0 F1o� C3arage ,�," Deak
Baeemer�t Carpart Potlo '
#8edrooms_ �B�throomt_ N��ting:OA3/OTHER or ELECTRtC(Cl�+ale Ons)
Are there any envlronmentally sensltive�,eas IocaEed on the parcel?
!/y�s,a oompletsd envfronrr�ntel checkllst must eccampeny perrnit epplloetlon.
cummma
ADDRES3 14 100t ve EMAIL
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