20150140 Permit Pkg 03202015Applicant:
City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20150140
Issue Date: 3/20/2015
(Work must be completed within 180 days)
Name: ADAM/TAMMY AUSTIN Phone
Address: 15332 91 ST AVE SE
YELM WA 98597
Property Information:
360- 960 -8107
Site Address: 15332 91ST AVE SE Owner: ADAM AUSTIN
Assessor Parcel No.: 41610015400 Subdivision: CHERRY MEADOWS Lot: 154
Contractor Information:
Name: SUNSET AIR INC Phone:
Address: TERRY MEDLOCK
5210 LACEY BLVD.
LACEY WA 98503
Contractor License No.: 10734 Expires: 12/31/2015
Project Information:
Project: MECHANICAL
Description of Work: INSTALLATION OF AIR CONDITIONER
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
SUNSET AIR INC
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 restri ions rec . If applying as a contractor, I further certify that I am currently
registered in the ton
Signature Date
Firm
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Mm
(36 ) 458 -3244
REC #: 00190306 3/20/2015 8 :14 AM
OPER: CO TERM: 001
REF #: 34803
PAID BY:
TRAN: 33.0000
20150140
AUSTIN,
15332 9
MECH
BUILDING PERMITS
29.50CR
ADAM /TAMMY
1ST AVE SE
29.50CR
TENDERED: 29.50 CHECK
APPLIED: 29.50-
CHANGE: 0.00
MAR /09/2015/MON 10;19 AM Sunset Air FAX No,360 456 4990 P,002
20 Sol 4!
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORMI t
Project Address: I tJ L J� A w T_ Parcel #: y I ul u o 5 'i 0-0
Subdivision: Lot #:T Plan #: Zoning:
❑ New Construction Li Re -Model / Re -Roof / Addition ❑ Home Occupation Sign
❑ Plumbing )"echahical ❑ Mobile / Manufactured Home Placement ❑ Other
Project Description /Scope of Work: UA( C.URbwJJA, n YW
Project Value: 5115, lo o
Building Area (sq. ft) 1 at Floor 2nd Floor 3`4 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 parcel?
If yes, a completed environmental checklist must accompany permit application.
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to] III CA So • 20 ;
LICENSE #
ADDR EMS S EMAIL
CITY %TA ZIP TI LEPHONE
TELEPHONE
ADDRESS EMAIL
CITY —STATF,, ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
- TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICE # EXP DATE CITY LICENSE #
ADDRE S '
CITY S AT
CONTRACTOR'S LICENSE #
TELEPIJON
EMAIL f-ti'l
P DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community S(?600ls, if applicable.
hereby certify that the above Information Is correct and that the construction on, and the occupancy and the use of the
ascribed property will be In accordance with the laws, rules and regulations of the State of Washington and the
Gity of elm.
App cant's S gnature I Date
Owner / Contractor / Owner's Agent 1 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
106 Velm Avenue We6t
yeltn' WA 98597
www.ci.ye1m.wa.us
(260) 4684144 FAX
MAR /09/2015/MON 10:19 AM Sunset Air FAX No,360 456 4990 P,001
SUNSET AIR, INC
PHONE: (360) 456 -4956 FAX: (360) 456 -4990
5210 LACEY BLVD. LACEY, WA 98503
FAX TRAN5MI55ION
TO,
DATE /TIME: �)l 911 M ►�R `� ��1
COMPANY: Citjt (� qjj nA,
FAX #: �Oo- -
FROM: ROMP MEYER - RTM@SUNSETAIR.COM
COMMENTS:
uxt
This transmission contains pages, including this cover page. If any page is
missing, please contact me at the above number.