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M-05-0204 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 0 rec ~ If applying as a contractor I futher certify that I am currently regist I the St of h' gt . City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Applicant: Name. All Seasons Inc. Address. 5001 N 28th St City' Tacoma Property Information: Site Address. 15037 105th Ave SE Assessor Parcel No 65080003400 Subdivision. Contractor Information: Name. Applicant Address. Contact: City' Contractor License No. Expires. Project Information: Project: Smith AlC Description of Work: 2-1/2 Ton Air Conditioner Sq. Ft. per floor (1 st) 0 (2nd) 0 (3rd) 0 Heat Type (Electric, Gas, Other) Fees. Item Item Fee Base Amt Mechanical Permit TOTAL FEES 33.25 $33.25 0.00 Applicant's Affadavit: Date Firm Unit Fee Permit No M-05-0204- YL Issue Date' 08/12/2005 (Work must be started within 180 days) Receipt No 37996 Phone: 253-879-9143 State: WA Zip 98407 Lot: Phone: State. Zip: Business License: Garage 0 Basement 0 Unit Rate No. Units Unit Desc 000 0.0000 o 0000 OFFICIAL USE ONLY # Sets of Prints. '~2/o Final Inspection: Date: 1'/11/05 ( / By' /,AI( Applicant: Name. All Seasons Inc. Address. 5001 N 28th St Project Information. Project: Smith A1C City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 ?I\\O \ t ?5J'iJ~ ~\.\b Of '{€,\..\A C\\'< City' Tacoma Description of Work: 2-1/2 Ton Air Conditioner Permit Fees Schedule Permit No M-05-0204-YL Phone. 253-879-9143 State. WA Zip 98407 Assessor Parcel No. 65080003400 Site Address. 15037 105th Ave SE Fees. Item Mechanical Permit Acct Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc o 0000 o 0000 032001-322-10-00 33.25 000 000 TOTAL FEES. $33.25 RECEIPT No 37996 RECEIVED *~A;*Tf{I~TY THF'EE DOIILAf'~ & co - L;' T t RECEIVED FROM !\LL ~;EA)nN I.NC 5~5(jl 1.1 l.cjTH' ~.JT DATE REC NO AMOUNT FiEF NO (L?;L_/05 ~~7~-I:):1 -' -' -~ J r~ (1 f ; --, 1"f T ~ C Ci 1-1]J" \11\ '::'B4, 7 :elrJLC;CT~F y ~[) ~~ ~~7:).~Clj44 r".r.,r!7T= 1 ,- , . rr -,p Ilr~ ({~UilTrlI.l1~Cr ,1'1'2 1. '"Jj-" l05T!i i\\r' ~jE . . . - .:.. ' -..'. RECEIPT No.3 715 8 RECEIVED ****THIRTY FIVE DOLLARS & 00 CENTS RECEIVED FROM ALL SEASONS INe 5001 N 28TH ST TACOMA WA 98407 253-278-9344 DATE REC. NO 07/01/05 37158 AMOUNT 35.00 CHECK REF NC 9246 BUDGETARY MICHELLE BUS LICENCE APPLICATION CITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM Project Address. lS03:t 1D5-f-Vl AU s.e Parcel#' Lo50'~OOO34CO R~C' E:/l JIJ.! 0 1 V~lJ , lOa} Subdivision I Lot #. ~ 3'?32.oB'l- Zoning, MPC o New Constructio~ 0 Re-Modell Re-Roof 1 Addition 0 Home Occupation Sign o Plumbing 8' Mechanical 0 Mobile 1 Manufactured Home Placement 0 Other Project Description/Scope of Work: I~SIAt-L 2'/2- -rr::>>J ~2.. SE8.- A-~ CO JJD 11l0UE:Q. Project Value 3400.00 Building Area (sq ft) 1 st Floor Basement 2nd Floor Carport Garage Patio Deck # Bedrooms_ # Bathrooms_ Heating GAS/OTHER or ELECTRIC (Circle One) Are there any environmentally sensitive areas located on the parcel? j..Jo completed environmental checklist must accompany permit application If yes, a Bt!)'!~@!J~K~X~~ttJ]~Ri.lliJ.~M~ .K l.\ J>r t..J <SJJ. l Tt\- ADDRESS I ~ 3'1- [D5+'" MJ€:. Se- EMAIL CITY ':\E:L~ STATE lOp.. ZIP q<aSC\-=f- TELEPHONE "6<cO- 4Co - 3.1<.cB A..RGj1!fI~j;~'T]~N~n~f$"~R ADDRESS CITY STATE ZIP LICENSE # EMAIL TELEPHONE GE'f~H~j:&~~:'B'qNhT~~~]GJ:R ADDRESS CITY STATE CONTRACTOR'S LICENSE # Pb~M.~IN.~.0~Nm.~<2ji1J0~ ADDRESS CITY STATE CONTRACTOR'S LICENSE # ZIP TELEPHONE EMAIL FAX EXP DATE CITY LICENSE # ZIP TELEPHONE EMAIL FAX EXP DATE CITY LICENSE # rI(1EpHANlcAL b'6'NTRACm~R AU- SE:A8:lI-JS /1-Jc. TELEPHONE 2<.;3- 2..:J-B-<1 ~44 ADDRESS roco I N ZCO+h 51 EMAIL CITY 'l^WN..fl<- STATEwA ZIP Q9401- FAX 2.S3-B=t'l-QI43 CONTRACTOR'S LICENSE # ALLSEJ:*0305SEXP 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 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 of Yelm. 00-3)- 2CD5 Applicant's I n ture Date Owner / Contra or I Owner's Agent I 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 105 Yelm Avenue West POBox 479 Yelm, WA 98597 (360) 458-3835 (360) 458-3144 FAX www.ci.yelm.wa.us Look Up a Contractor, Electnclan or Plumber LIcense DetaIl Page 1 of 3 Topic Index Contact Info Safety Claims & Insurance Workplace Rights Find a Law or Rule Get a Form or Publication Look Up a Contractor, Electrician or Plumber General/Specialty Contractor A business registered as a construction contractor with Lal to perform construction work within the scope of its specialty A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance License Information License ALLSEI*03055 Licensee Name ALL SEASONS INC Licensee Type CONSTRUCTION CONTRACTOR UBI 601811007 Verify Workers ComR Premiwm SJatus i Ind. Ins. Account Id 87655701 Business Type CORPORATION Address 1 5001 N 28TH ST Address 2 City TACOMA County PIERCE State WA Zip 98407 , Phone 2532789344 Status ACTIVE Specialty 1 AIR CONDITIONING Specialty 2 AIR HEAT,VENTILATION,EVAPORAT Effective Date 8/25/1997 Expiration Date 12/17/2005 Suspend Date Separation Date Parent Company Previous License ALLSEC0770M Next License Associated License Business Owner Information I https.//fortress.wa.gov/lm/bbI p/Detai1.aspx?L1cense= ALLSEI*03 055 7/5/2005 Look Up a Contractor, Electnclan or Plumber LIcense DetaIl Page 2 of3 Effective Expiration Name Role Date Date AMBUR, KEN PRESIDENT 08/25/1997 BRADSHAW, VICE DAVID PRESIDENT 08/25/1997 Bond Information i Bond Bond Company Account Effective Expiration Cancel Impaired Bond Received Bond Name Number Date Date Date Date Amount Date GREAT AMERICAN INS CO OF Until #4 NY 790286562422 08/15/2002 Cancelled $6,000 00 07/19/2002 INDEMNITY INS CO OF N Until #3 AMERICA CWACS62422 12/05/2001 Cancelled 08/18/2002 $6,000 00 07/19/2002 , INDEMNITY INS CO OF N [#2 AMERICA CWACS62422 08/15/2000 12/05/2001 $4,00000 DEVELOPERS Until #1 INS CO 441846C 08/22/1997 Cancelled 08/28/2000 $4,000 00 , " .... Savings Information No Matching Information I: Insurance Information i Company Policy Effective Expiration Cancel Impaired Received Insurance Name Number Date Date Date Date Amount Date WESTERN NATIONAL #7 ASSURANCE CP300006684 03/28/2005 03/28/2006 $1,000,000 00 05/02/2005 AMERICAN STATES INS 01 CE152827- #6 CO 90 12/17/2004 12/17/2005 $1,000,000 00 11 /17/2004 AMERICAN STATES INS #5 CO 01CE152827 12/17/2003 12/17/2004 $1,000,000 00 12/15/2003 AMERICAN STATES INS #4 CO 01CE152827 12/17/2002 12/17/2003 $1,000,000 00 12/23/2002 SAFECO INS CO OF #3 AMERICA 01CE152827 12/17/2001 12/ 17/2002 12/11/2001 AMERICAN STATES INS #2 CO 01CE152827 12/17/1999 12/ 17/2001 11/21/2000 AMERICAN #1 STATES 01CE15282710 12/17/1996 12/17/1999 ..,",.., , .", Summons I Complaints Information . . . https.//fortress.wa.gov/lmlb bIp/Detail.aspx?LIcense= ALLSEI*03 055 7/5/2005 Look Up a Contractor, Electnclan or Plumber LIcense Detml Page 3 of3 Tax Summons I Cause Warrant Dismissal Complaint Complaint Judgement Judgemer Complaint Number Id Plaintiff County Date Date Amount Date Amount KELLER SUPPLY #1 992003681 CaiNe THURSTON 08/2412000 03/08/1999 $1,303 69 $000 Start a New Searcb E'rtnter F[.i.endly~le.Lsion About Uti I Find a job at L&I ! Informacion en 1-800-547-8367 I Site Feedback I C"!-'w3sl1ington '/ashingtcJn Aate Depr. or LiDor ~nd Indljstrips Use of this ;lte is SIJDJe,-t to the laws of the state of vYashingtol1 i\cceSf:i ;-\~~r:.:;ement I Start ont !.llIk Zlnd 5ccur1t.; 5taternefl I Intended use extei ndt Lontent po! -, Visit ]rcess 4a.gov https.l/fortress.wa.gov /lmlbblp/Detall.aspx?LICenSe= ALLSEI* 03 05 5 7/5/2005