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20140278 Permit Pkg 11182014 - _ '�'o� ''HEp,p�` City of Yelm Permit No.: 20140278 � , � � Community Development Department Issue Date: 11/18/2014 (Work must be completed within 180 days) Building Division Phone: (360)458-8407 LM ""`F"'"`T�" Fax: (360)458-3144 Applicant: Name: DOUG/SHELIA POLASCHEK Phone: 253-905-0714 Address: 9526 SOLBERG CT SE YELM WA 98597 Property Information: Site,4ddress: g526 SOLBERG CT SE Owner: SHEILA POLASCHEK Assessor Parcel No.: 70190000600 Subdivision: Lot: Contractor Information: Name: BLACK HILLS, INC Phone: Address: 1003 85TH AVE SE OLYMPIA WA 98501 Contractor License No.: 10091 Expires: 12/31/2014 Project Information: Project: MECHANICAL Description of Work: REPLACE FURNANCE Sq. Ft. per floor: First Heat Type(Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor Fees MECHANICAL BLACK HILLS, INC $ 29.50 TOTAL FEES: $ 29.50 ApplicanYs Affidavit: OFFICIAL USE ONLY I ceRify 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 State f Washington. Signature �� Date ��'l�-l�/ Date: Firm %j��Gk ��3 � �rtG. By. ♦ Cit� of Y�lm (36 ) 458-8402 REG#. Q01��8608 11/18/2014 1:17 PM npFR: CO TERM: 001 REF#: 15517 TRAN: 33,0000 BUILDI�g 50CRITS 20140278 pOLASCHEK, DO'�G/SFIELIA 9526 SOLBERG C729��pC� MECH TENOERED: 29.50 CHECK APPLIED: 29050- CHANGE: � 0 00 Z�iuo �� CITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM ;��__, _ Project Address:`"1�7��{� ��>�?�. �� i�Il �-'�� Parcel#: '1 L��l L%'CC��C.-(,t Subdivision: Lot#: Plan#: Zoning: -: New Construction � Re-Model/Re-Roof/Addition Home Occupation Sign - Plumbing '�S,Mechanical - Mobile/ Manufactured Home Placement � Other r Project Description/Scope of Work: J��.1�,'�G�t't�_._- �L�'ll_��.i Project Value:_ __•.��G C:'-C Building Area (sq. ft) 15`Floor 2"d Floor 3`d Floor Garage-2 car 3 car Covered Patio Covered Porch Patio Deck #Bedrooms_ # Bathrooms_ Heating: GAS/OTHER or ELECTRIC (Circle One) Are there any environmentally sensitive areas located on the parcei? If yes, a completed environmental checklist must accompany permit application. BUILDING OWNER NANJE: � L� Ci � ` �ti� � ADDRESS � 5<:� S��I i` r�c;C# 5 °� EMAIL CITY � ��. r STATE r,�- (-� ZIP�i5`>a�7 TELEPHONE � C`>i -= I�S' -C�,�-j ARCHITECT/ENGINEER LICENSE# ADDRESS EMAIL CITY STATE ZIP TELEPHONE GENERALCONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE# PLUMBING CONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE# MECHANICAL CONTRACTOR''� ', % � � I �' ( TELEPHONE � � ?— S-4'�;��` ADDRESS �`_�t -, °r, �,ix�,r_��,��, �� EMAIL ��f.<<<iH�(�� C�c c.h(�l[S %d�ic_.�� CITY �� 'L, ��j,� 'i r.� � STATE t�� ZIP '1 'S2�( FAX CONTRAC OR'S LICENSE#i;�i�-'tCKI-I 1 C��r.��EXP DATE CITY LICENSE# L�{i ' �' '�'"?S(. C' � i�+,�9c, Copy of mitigation agreement with Yelm Community Schools, if applicable. 1 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 State of Washington and the City Yelm. ,. --� . - � � ( i� I� App icant's 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 Yelm, i�'A 98597 (360)458-3144 FAX www.ci.yelm.wa.us � � i � ' ' A � # �-�' � � -�� ,<. � I � Duct Leakage Affidavit(Existing Construction) Permit#: '� �-'� `"i �<%� ' � House address or lot number: �'J��C' ��t �i'�G► l.� J � City: � � .YY'1 Zip: `"I � LJC� � Cond. Floor Area(ft2): � �`"�� Source(circle one): Plans Estimated Measured ❑ Duct tightness testing is not required for this residence per exceptions listed at the end of this document Air Handier in conditioned space?�yes� no Air Handler present during test?�yes�no Maximum duct leakage(check rraethod used): ❑Method 1 Total duct leakage, air handler instalied: (floor area x.08)_� I ?�CFM@25 Pa ❑ Method 2 Leakage to outdoors: (floor area x.06)= CFM@25 Pa i'est Resuit: Z j; �— CFM@25Pa Ring(circle one): Open 1 2 � {' c�� /1} �, /'' Duct Blaster Location: i��"t �jy—'��U''� �Pressure Tap Location: � i.t}�t"I�- �C.� �t �4 �� C�(�� ❑Method 3 The measured duct leakage shall be reduced by more than 50%relative to the measured leakage prior to the installation or replacement of the space conditioning equipment. A visual inspection including a smoke test shall demonstrate that all accessible leaks have been sealed. Pre-installation test result: CFM@25Pa Post installation test result: CFM@25Pa Post instailation leakage rate must be less than 50%of pre-installation rate Company Name: ��c�G`� t��S ti:'IL. Duct Testing Technician: \`r �`��" ��n�c�1 Date:__ � � / � �� Phone Number: ❑Method 4 If it is not possible to meet the duct requirements of 1, 2 or 3, all accessible leaks shall be sealed and verified through a visual inspection and a smoke test by a certified third party. i certify that these duct leakage rates are accurate and determined using standard duct testing protocol and all accessible leaks have been sealed. Company Name: Certifed Third Party: Date: Washington State Energy Code reference: 101.3.2.6 Mechanical Systems:Those parts of systems which are altered or replaced shall comply with Section 503 of this Code when a space-conditioning system is altered by the installation or rep�acement of space-conditioning equipment(including replacement of the air handler,outdoor condensing unit of a split syslem air conditioner or heat pump,cooling or heating coil,or the fumace heat exchanger),the duct system that is connected to the new or replacement space-conditioning equipment shall be sealed,as confirmed through field verification and diagnostic testing in accordance with procedures for duct sealing of existing duct systems as specified in the RS33,to one of the following requirements. Excep4ions:t.Duct systems that are documented to have been previously seated as confirmed through field verification and diagnostic testing in accordance with procedures in RS-33. 2.Ducts with less than 40 linear feet in unconditioned spaces. 3.Existing duct systems constructed,insulated or sealed with asbestos.