20140228 Permit Pkg 08062014 '�'�a� T"�A,��` City of Yelm Permit ►vo.: 20140228
�
4 � Community Development Department Issue Date: 8/06/2014
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
Y L
'".`","`_°" Fax: (360)458-3144
Applicant:
Name: GAIL PRICE Phone: 360-400-4267
Address: 15722 92ND CT SE
YELM WA 98597
Property Information:
Site Address: 15722 92ND CT SE Owner: GAIL PRICE
Assessor Parcel No.: 55360002900 Subdivision: Lot:
Contractor Information:
Name: FAST WATER HEATER Phone:
Address:
12601 132 ND AVE. SE
KIRKLAND WA 98034
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: PLUMBING
Description of Work: REMOVE AND REPLACE GAS WATER
Sq. Ft. per floor: First Heat Type(Electric,Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
PLUMBING FAST WATER HEATER $ 27.00
TOTAL FEES: $ 27.00
Applic Ys Affidavit: OFFICIAL USE ONLY
I certif that I have read and examined the information contained within the application and know the same
to be ue and I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints:
Yelm egula ns inclu �ng those governing zonjRg afld land subdivision, and in addition,all covenants,
ease ents d restr ions of recor . If applying as a contrador,I further certify that I am currently Final Inspection:
regist red i St e of Wash gt .
Signat re Date
Date:
Firm By�
Cit af $eam02
(36�)
REC#: 00168348 8/06/2014 ��5� p�
OPER: CO TERM: 001
REF#: 17500
TRAN: 33.0�00 BUILQI�� �OCRI�S
201�0228
PRICE, GAIL
15722 g2ND GT S�� DOCR
pL
TENDERED: 27.00 CHECK
APPLIED: 27.00-
CHANGE: 0.00
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708984
CITY OF YELM �I �O �—`�-�
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address:15722 92 CT SE Parcel#: 55360002900
Subdivision: Lot#: Zoning;
0 New Construction ❑ Re-Model/Re-Roof/Addition ❑ Home Occupation Sign
D� Plumbing ❑ Mechanical ❑ Mobile/Manufactured Home Placement ❑ Other
Project Description/Scope of Work: Remove/Replace Gas Water
Project Value� � �
Building Area(sq.ft) 1 S`Floor 2°d 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? If yes,a
completed Pnvironmental rhecklist must accampany oermit application.
BUILDING OWNER NAME: PRICE MELVIN
ADDRESS 15722 92 CT SE EMAIL
CITY YELM STATE WA ZIP 98597 TELEPHONE541 261-6623
ARCHITECT/ENGINEER LICENSE#
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL.GONTRACTORFAST WATER HEATER COMPANY TELEPHONE � -
ADDRES511715 N. CRE EMAIL� � fastwaterheater.com
CITY BOT STATE ZIP FAX 415-636-7055
CONTRACTOR'S LICENSE# FASTWWH948BC EXP DATE�i4 'Y LICENSE# 1048
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE_CITY LICENSE#
MECHANICAL GONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE_CITY LICENSE#
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 described property will be in accordance with the laws,rules and regulations of the 5tate of Washington and the
City of Yelm. �;
���.,� 7/29/14
ApplicanYs Signature Date
Owner/Contractor/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
I05 Yelm Auenue West (360)458-3835
PO Box 479 (360)458-3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us
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AUG 0 � 2014
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