20150134 Permit Pkg 03062015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20150134
Issue Date: 3/06/2015
(Work must be completed within 180 days)
Applicant:
Name: JON & TAMMY MATTHEWS Phone: 913 - 547 -0925
Address: 15538 CHAD DR SE
YELM WA 98597
Property Information:
Site Address: 15538 CHAD DR SE Owner: JON AND TAMI MATTHEWS
Assessor Parcel No.: 41610003300 Subdivision: CHERRY MEADOWS
Contractor Information:
Name: KLIEMANN BROS. Phone:
Address:
4703 116TH ST. E
TACOMA WA 98446
Contractor License No.: 10407 Expires: 12/31/2015
Project Information:
Project: MECHANICAL
Description of Work: HEAT PUMP INSTALLATION
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
KLIEMANN BROS.
TOTAL FEES:
Applicant's Affidavit:
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
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
registered in the State of Washington. t
Signature rn,,,�,N Y� � �l Date
Firm
Lot: 33
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Mm
(36) 458 -3244
REC #: 00188548 3/06/2015 9 :26 AM
OPER: CO TERM: 001
REF #: 51010
PAID BY:
IRAN: 33.0000 BUILDING PERMITS
20150134 29,50CR
MATTHEWS, JON & TAMMY
15538 CHAD DR SE
MECH 29.50CR
TENDERED: 29.50 CHECK
APPLIED: 29.50 -
CHANGE: 0.00
Mar. 1 2015 4:25PM Kliemann Bros HVAC No. 6234 P. 1
L
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 651 r SE Parcel #'__ 10 V V o
Subdivision: Lot # :-3-3- Plan #- _ Zoning' S IF D
❑ New Construction ❑ Re -Model / Re -Roof / Addition ❑ Horne Occupation Sign
❑ Plumbing Mechanical ❑ Mobile / Manufactured Home Placement ❑ Other
Project Description /Scope of Work:
Project Value:. 4.%0
Building Area (sq. ft) I"' Floor 2"d Floor SO Floor Garage -2 car 3 car
Covered Patio Covered Porch _ Patio Deck
# Bedrooms_., # Balhrooms_ 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.
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# EXP DATE CITY LICENSE #
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STAT ZIP FAX
EXP DATE CITY LICENSE #
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CONT ACTOR'S LICENSE #j EXP DATE CITY LICE=NSE #_ /
1 M I T 1 �'chools, Copy of mitigation agreement wan Ye m Comm pity 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 lawn, r+uter and regulations of the State of Washington and the
City of Yelm.
3-.3 `, �r
App ant' grnt a Date
Owner ontract wner's Agent I Contractor's Agent (Please circle one.)
All perms s are non - transferable and wilt 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
105 Ye11n Avenue We8t
Yelm, {YA 88597
rVWW.Ci.ye11?1. Wa.US
MAR 0 4 2015
(960) 468 -3835
(360) 458 -3144 FAX
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