20150191 Permit Pkg 05152015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: STEPHANIE DOOMS
Address: 16183 BIRKLAND ST SE
YELM WA 98597
Property Information:
Site Address: IAIA'1 RIPWI Amn ST SF
Assessor Parcel No.: 32660000800
Contractor Information:
Name: BOB'S HEATING & AIR
Address:
13633 NE 126TH PLACE #425
KIRKLAND WA 98034
Contractor License No.: 10102
Permit No.: 20150191
Issue Date: 5115/2015
(Work must be completed within 180 days)
Phone: 253 - 651 -0859
Owner: STEPHANIE DOOMS
Subdivision: AUTUMN HILL. P. II
Expires
Phone:
12/31/2015
Project Information:
Project: MECHANICAL
Description of Work: ADD AC UNIT TO EXISTING HVAC SYSTEM. DUCT TEST REQUIRED
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
BOB'S HEATING & AIR
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 th State of Washington _
Signature �L'2' " Date /�����
Firm 00 rs �� ✓ ��
Lot: 8
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Mm
(36 ) 458 -3244
REC #: 00195619 5/15/2015 2 :44 PM
OPER: CO TERM: 001
REF #: 505188
PAID BY:
TRAN: 33.0000 BUILDING PERMITS
20150191 29.50CR
DOOMS, STEPHANIE
16163 BIRKLAND ST SE
MECH 29.50CR
TENDERED: 29.50 CHECK
APPLIED: 29.50-
CHANGE: _ 0
05/12/2015 TUE 1$:20 FAX
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
W5D it-at 1
Project Address; 16183 Birkland St SE parcel #: 3266000080
_
Subdivision: Lot #: Plan #:_ Zoning:
❑ New Construction o Re -Model 1 Re -Roof / Addition n Home Occupation Sign
❑ Plumbing 6J Mechanical ❑ Mobile / Manufactured Home Placement ❑ Other
Project Description /Scope of Work: add ac to existincr hvac system
Project Value: 5 2 0 0
Building Area (sq. ft) 1" 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 parcel7 n o
M yea, a completed environmental checklist must accompany permit application.
1 b N,i : Stephanie Dooms
ADDRESS 16183 Birkland St SSE EMAIL
CITY YaJM STATE wa XIP 9 8 5 9 7 TELEPHONE (2 5 3) 6 51- 0 8 5 9
0H1 4T/F JNEg LICENSE #
ADDRESS EMAIL
CITI(._STATS= ZIP rTELEPHONE
.. TELEPHONE
ADDRESS EMAIL
CITY STATE Zip FAX
CONTRACTOR'S LICENSE # EXP DATE—CITY LICENSE #
mom ,CKII Y . , P TELEPHONE
ADDRESS EMAIL
CITY FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE: #_
CH, t to Bobs ea In TELEPHONE 800-840-
141 1 §�� ��2gth EMAIL osne o s ea n .com
CITY KIrkland S7A# AZ97 98�o TL-'s13 �11Y LICENSE # 1 s- 000303.0
GONTRACTOR'S LICENSE #
Copy of mitigation agreement with Yelm Community Schools, If applicable.
1 hereby carttty thato above Inknratlon Is correct and that the aonstructlon on, and the oacupency and the use of the
above desartbed arty will be In aceordance with the laws, rvlee and ulstlons of the State of Washington and the
City of Yalm, ��
5/12/15
Owner ! "tractor / Owner's Agent 'Contractor's Agent (Please circle one.)
All p mlts are non4ranaferabls snd will expire If work authorized by such permit Is not begun
with 190 days of Issuance, or I} work is suspended or abandoned for a period of 180 days
0002/002
106 Yalm Avenue Wert (860) 46&866Q'
Yalm, WA 96697 (8e0) 458- -8144 FAX
mmeu.clYelm wa.rsr )' T V ED
MAY 13 2015
BY,,
05/12/2015 TUE 18:20 FAX
Bob's Heating & Air Conditioning
14148 NE 190" St
Woodinville, WA 98072
Fax: (425) 482 -3742
Date:
Company: Bob's Heating and Air
Attn: Pen-nits
From: Bobs Heating and Air
Pages (including cover): 2
Notes:
Please call our office with any questions and /or for payment.
206 - 378 -6723
0001 /002