20140230 Permit Pkg 08132014 Permit No.:
�pF �HFp� City of Yelm 20140230
7
� � Community Development Department Issue Date: 8/13/2014
d � (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
EL
"""`"'"`"°" Fax: (360)458-3144
Applicant:
Name: ELIZABETH CULP Phone: 817-308-8231
Address: 10042 COCHRAN AVE SE
YELM WA 98597
Property Information:
Site Address: 10042 COCHRANE AVE SE Owner: ELIZABETH CULP
Assessor Parcel No.: 56510002700 Subdivision: JOHNS MEADOWS Lot: 27
Contractor Information:
Name: BRENNAN HEATING Phone:
Address:
4601 S 134TH PL
SEATTLE WA 98168
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: MECHANICAL
Description of Work: INSTALLATION OF AC UNIT
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 ceRify 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.
w- - 1 g �1,3���j� Date:
Signature �U"W Date
F��, t�R �N�� f�P�/rtt� �-J�-C� BY�
Cit� of Y�lm
c3� ) a�a-saa�
REC#: OU169115 8/13/2014 1 :16 PM
OPER: CO TERM: 001
REF#: 41064
TRAN; 33.0000 BUTLGING PERMITS
2i1140230 29.50CR
CULP, ELIZABETH
10042 COCHRANE AVE SE
MECH 29.50CR
TENDEREU: 29.50 CHECK
APPLIED: 29.50-
CHANGE: 0.00
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a� �
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address:I OO�� C oc,�n ra..n.� �'a�i#: �5 I Ob p �`�.-e�c�
Subdivision: Lot#: Plan#: Zoning:
❑ New Construction` ❑ Re-Model/Re-Roof/Addition ❑ Home Occupation Sign
❑ Plumbing �Mechanical o Mobile/Manufactured Hame Piacement ❑ Other
Project DescriptioNScope of Work:.� Y��.Q„�� (�L �
Project Value: o�t �D�
Building Area(sq.ft) 1�`Floor 2nd Floor Garage Deck
Basement Carport Patio
#Bedrooms_ #Bathrooms_ Heating:GA /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.
BUILDING OWNE �� V
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE �O
ARCHITECTlENG1NEER LICENSE#
ADDRESS EMAIL
C�T1' STATE ZIP TELEPHONE
GEIVERAL CC31VT(�AG'Tt7R TELEPHONE
ADDRESS EMAIL
C��1' STATE ZIP FAX i
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
MECHANICAL CO TRAC70R EL PHONE p
ADD SS �. EMAI '1 � , LpYy1
C��',s � STAT ZI FAX • �
CONTRACTOR'S LICENSE# P DAT CI LICENSE#
Copy of mitigation agreement with Yelm Community Scho s, i applicable.
1 he by oertify that the above infortnation is correct and that the construcUon on,and the oecupancy and the use of the
ov descrtbed propertyr will be in accordance wlth the taws,rules and regulations of tha State of Washtngton and the
ity o Yelm.
` 1 � I �_
plicant's Signature Date
wner/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
�
Y06 Yelm Avenue West (360)458-3835
Yetm,WA 98697 (360)458-3I44 FAX
wwm.ci.yelm.waus