PL-05-0036
.,
City of Yelm
Community Development Department
Building Division
Phone (360) 458-8407
Fax: (360) 458-3144
Permit No
PL-05-0036- YL
Issue Date 02/04/2005
(Work must be started within 180 days)
Receipt No
35483
Applicant:
Name. Fast Water Heater
Phone.
425.814.3124
Address. 12601132nd Ave NE
City' Kirkland
State' WA Zip 98034
Pl"cjper1Ylnformation.
Site Address: 916 Crystal Springs Road
Assessor Parcel No 22719210300
Subdivision.
Lot:
Contractor Information
Name
Contact:
Phone
Address.
City'
State
Zip
Contractor License No
Expires.
Business License.
Projectlhfor!llatiots:
Project: Gaye Water Heater
Description of Work: Remove/replace electric water heater
Sq. Ft. per floor' (1 st) 0
Heat Type (Electric, Gas, Other):
(2nd) 0
(3rd) 0
Garage 0
Basement 0
Fees:
Item
Item Fee
Base Amt
Unit Fee
Unit Rate
No Units Unit Desc
Plumbing Permit
TOTAL FEES
2700
$27.00
2000
700
7 0000
1 0000 Fixture
Applicant's Affcldavib
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 futher certify that I am currently
registered in the State of Washington.
/tv!?j!
GFFICIACUSE ONLY
#Sets..of Prints.
Firm
Final Inspection.
:Date~/tJ~/JrPs
~y.f;
Signature
City of Yelm
Community Development Department
Building Division
Phone' (360) 458-8407
Fax: (360) 458-3144
Permit No
P L-05-0036- YL
Issue Date 02/04/2005
(Work must be started within 180 days)
Receipt No
35483
Applicant:
Name. Fast Water Heater
Phone.
425.814.3124
Address: 12601132nd Ave NE
City' Kirkland
State WA Zip 98034
Property Information
Site Address: 916 Crystal Springs Road
Assessor Parcel No 22719210300
Subdivision.
Lot:
Contractor Information
Name.
Contact:
Phone.
Address.
City'
State.
Zip'
Contractor License No
Expires.
Business License:
Project Information.
Project: Gaye Water Heater
Description of Work: Remove/replace electric water heater
Sq. Ft. per floor' (1st) 0
(2nd) 0
(3rd) 0
Garage 0
Basement 0
Heat Type (Electric, Gas, Other).
Fees.
Item
Item Fee
Base Amt
Unit Fee
Unit Rate
No. Units Unit Desc
Plumbing Permit
TOTAL FEES
2700
$27.00
20.00
700
7 0000
1 0000 Fixture
J ?I~\O(
Y
J)~
Applicant's Affadavit:
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 futher certify that I am currently
registered in the State of Washington.
OFFICIAL USE ONLY
# Sets of Prints.
Final Inspection.
Signature
Date
Date:
Firm
By'
City of Yelm
Community Development Department
Building Division
Phone (360) 458-8407
Fax: (360) 458-3144
Permit Fees Schedule
PAID
FEB 0 4 2005
CITY OF YELM
Permit No PL-05-0036-YL
,~7 LlC03
Applicant:
Name: Fast Water Heater
Phone.
425.814.3124
Address: 12601132nd Ave NE
City' Kirkland
State' WA Zip 98034
Project Information
Project: Gaye Water Heater
Description of Work. Remove/replace electric water heater
Site Address. 916 Crystal Springs Road
Assessor Parcel No. 22719210300
Fees
Item
Acct Code
Item Fee Base Amt Unit Fee
Unit Rate No Units Unit Desc
Plumbing Permit
032 001-322-10-00
2700
2000
700
7 0000
1 0000 Fixture
TOTAL FEES
$27.00
. . .
- t:. . D .
RECEIPT No. 35483
.... -..... --.,
I
RECEIVED
****TWENTY SEVEN DOLLARS & 00 CENTS
RECEIVED FROM
DATE REC. NO
AMOUNT
REF NO
FAST WATER HEATER COMPANY
12601 132ND AVE NE
KIRKLAND, WA 98034
1-800-454-8955
02/04/05 35483
27.00 CHECK
2014
MISCELLANEOUS RECEIPT
GRETCHEN
PL-05-0036-YL
...
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Project Address:
Subdivision.
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
916 Crystal Spring Rd ParcelU' 22719210300
LotU'
Zoning,
o New Construction 0 Re-Modell Re-Roof I Addition 0 Home Occupation Sign
fill Plumbing 0 Mechanical 0 Mobile / Manufactured Home Placement 0 Other
Project Description/Scope of Work: Remove/replace electric water heater
Project Value: ~ 4 gOO
Building Area (sq. ft) 1S1 Floor
Basement
2nd Floor
Carport
Garage
Patlo
Deck
# Bedrooms_
U Bathrooms_
Heating: GAS/OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application
~t1t~Q1N.<3:,;,P.wN.gil~~AM:$.: Randy ITanya Gaye
ADDRESS916 Crystal Spring Rd
CITY Yelm STATE WA . ZIP 9R"iQ7 TELEPHONE1hO A.t:;R ?01 R
ARGHit.ECT:/.r:NGJN~~~
ADDRESS
CITY STAT!;
LICENSE #
".
ZIP
TELEPHONE
X5~~~~C?~~~~~~F~~~ :~ter Heater TELEPHONE 425-814-3124
CITY Kirkland STATE WA ZIP980~4 FAX 42S R14 9S16
CONTRACTOR'S LICENSE # FASTWHCO 5 2DEXP DATE CITY LICENSE /I O"i 0 0 1 n A. R
2-16-07
TELEPHONE
PLUMB I NG".co'N.'rFlAcT-OFl
ADDRESS
CITY STATE
CONTRACTOR'S LICENSE /I
ZIP
FAX
EXP DATE
CITY LICENSE #
MECIlANICAL CONTRACTOR
ADDRESS
CITY STATE
CONTRACTOR'S LICENSE #
TELEPHONE
ZIP
FAX
EXP DATE CllY 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.
-'." /!!k/":;/,,~ ~ _~:T-05- ".
!Appllc~nt's Signature: / " .. Date
_h":Ow_~"erj_~rj Owner's. AQerit / Contractor's Agent (Please circleOiie.) .:::
. 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