20140288 Permit Pkg 12152014 '��o� rHFp,��'' City of Yelm Permit►vo.: 20140288
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� Community Development Department Issue Date: 12/15/2014
(Work must be completed within 180 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: 14834 99TH AVE SE Owner: BILL CUMMINS
Assessor Parcel No.: 78640018200 Subdivision: TAHOMA TERRA Lot: 182
Contractor Information:
Name: AMERICOOL HEATING Phone:
Address:
17929 IRWIN RD SW
ROCHESTER WA 98579
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: MECHANICAL
Description of Work: INSTALLATION OF DUCTLESS HEAT PUMP
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
MECHANICAL AMERICOOL HEATING $ 29.50
TOTAL FEES: $ 29.50
Applicant's 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 ons of record. If applying as a contractor, I further certify that I am currently Final Inspection:
registere � he State o Washington.
� � Date:
Signaure --------------�-�— Date
Firm gy�
Cit� af Y�lm
(36 ) 458-8402
REC#: 00180809 12/15/2014 12:07 PM
OPER: CO TERM: 001
REF#; 7655
TRAN: 33.0000 BUILDING PERMITS
20140288 29.50CR
CUMMTNS, WILLIAM
14834 99TH AVE SE
MECH 29.50CR
TENDEREQ: 29.50 CHECK
APPLIED: 29,50-
CHANGE: 0.00
oLJu� `'v"c�L��
CITY Of Y�LM
RESIDENTIAL BUILDING PERMIT APPUCA7lON FORM
Project Address: �p�
�� �i'3� ��� � 5� Parcel#: ��&�� �U� 820f1
5ubdivision:�!��� `r�� �7 Lot#'—� $�'- Plan#: 3�� �Z Zoning'�f+`'�✓
�� New Construction : Re-Model/Re-Roof l Addition � Hom�Occupation Sign
�� Plumbing
I� Mechanical Mobite/Manufactured Home Placement ! � Other
Project DescriptionlScope of work: ������f�� ��r��5 ��� Pv
Project Value: �� �����
Building Rrea(sq.�t) 1g`Floor 2nd Floor 3ro Floor Garage�2 car 3 car
Covered Patio Covered Porch Patio Deck
#Bedrooms� #�athrooms� Heating: GAS/OTH�R or EL�CTRIC(Circle One)
Are Chere any environmentally sensitive areas located on the parcel? I�cation.
lfyes, a completed environmenta!checklist must accompany permit app'
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Copy of mitigafion agreement with Y�Im Commurnty 5choo s, if applicable.
1 heraby ce tt�at the above information ta correct and thatthe canstruction on,and the occupancy and the use of the
ehovA ds rib pro will be in accordance with the laws,rulas and regutations of the State af Washington and the
City of Y fm.
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Ap I an ' ' Date
Ow er Contractor wner's AgenC I Contractor's Agent(Please ctrcle one.)
All permlts are non-transferaBle and�nrill expire if work authorized by such permit is not begun
withfn 180 days of issuance,or if work(s suspended or abandoned for a period of 780 days
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12.ochester,�'A 98579
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