20140279 Permit Pkg 11192014 �o� rH�o,� City of Yelm Permit No.: 20140279
�
� � Community Development Department Issue Date: 11/19/2014
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
L
"'•�`"'"�_°" Fax: (360)458-3144
Applicant:
Name: MICHAEL&WINO MANN Phone: 360-458-9368
Address: 9808 RAMSAY DR SE
YELM WA 98597
Property Information:
site Address: g$08 RAMSEY DR SE Owner: MIKE MANN
Assessor Parcel No.: 69240003100 Subdivision: Lot:
Contractor Information:
Name: WASHINGTON ENERGY SERVICES Phone:
Address:
3909 196TH ST SW
LYNNWOOD WA 98036
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: MECHANICAL
Description of Work: REPLACE GAS WATER HEATER
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
MECHANICAL WASHINGTON ENERGY SERVICES $ 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 t State Washin ton.
Signature Date p�� Date:
Firm p�/l. W _S� (S By:
�
�oF TH�A,��' City of Yelm Permit No.: 20140279
�
� � Community Development Department Issue Date: 11/19/2014
(Work must be completed ithin 180 days)
Building Division
Phone: (360)458-8407
ELM
�"'"�""°" Fax: (360)458-3144 %�
i'
/
Applicant: ��
Name: HARDING GREENS P�e: 360-458-9368
Address: P.O. BOX 71 `
YELM WA 98597
Property Information:
s�te ada�ess: 107 WASHINGTON AVE SW owne�: nniKE Ma,NN
Assessor Parcel No.: 75301600700 Subdivision: Lot:
Contractor Information:
Name: WASHINGTON ENERGY SERVICES Phone:
Address:
3909 196TH ST SW
LYNNWOOD WA 98036
Contractor License No.: "�� Expires: 0/00/0000
Project Information:
Project: MECHANICAL
Description of Work: REPLACE GAS WAT�HEATER
Sq. Ft. per floor: First � Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
MECHANICAL WASHINGTON ENERGY SERVICES $ 29.50
TOTAL FEES: $ 29.50
ApplicanYs Affidavit: OFFICIAL USE ONLY
I certify that I have read and ex ined 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 State of Washington. �
Signature %� Date � �� Date:
c
Firm ���S� � By�
Git of Y�lm
t���) 45s-�4oz
REL'#: 00178689 11/19I2014 3:23 PM
ppER; CO TERM: 001
REF#: 1849
TRAN: 33.Ot�00 �U�LQ�29.�OCRITS
20140279
HARDING GREENS
1Q7 WASHINGTON ��E�OCR
MFCH
TENOEREG: 29.50 CHECK
APPLIECI; 29,50-
CHANGE; � ���
���� ���
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 107 WASHINGTON AVE SW Parcel#: 69240003100
Subdivision: Lot#: Zoning;
New Construction � Re-Model/Re-Roof/Addition Home Occupation Sign
Pfumbing �Mechanical Mobile/Manufactured Home Placement Other
Project�escription�scope of work: REPLACE GAS WATER HEATER
Project Value:
Building Area(sq. ft) 1 St 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 environmental checklist must accompany permit application.
BUIL�iNG OWNER NAME: MiKE MANN
ADDRESS 980�RAMSAY DR SE EMAIL
CITY YE�M STATE WA ZIP 98597 TELEPHONE 360-458-9368
ARCHITECTlENGINEER LICENSE#
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR Washington Energy Services TELEPHONE $00-398-4663
ADDRESS 3909 196th St SW EMAIL
CITY �ynnwood STATE wA ZIP 98oss FqX
CONTRACTOR'S LICENSE# WASHIES9710F3 EXP DATEsi�S CITY LICENSE# 3oso�
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
MECHANICAL COIUTRACTOR 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 Yhe use of the
above described property will be in accordance with the laws,rules and regulations of the State of Washingto�and the
City of Yelm.
� f �_� �`
Applicant's Signature Date �
Owner/Contractor/Owner's A�c �L/Contractor' A ent lease 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
NOV 19 2014 �
105 Yelm Auenue West (360)458-3835 f
PO Box 479 (360)458-3144 FAX
�
Yelm, WA 98597 wwui.ci.yelm.ur¢.us --. --__-_°