PL-05-0272
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
PL-05-0272-YL
Issue Date. 09/07/2005
(Work must be started within 180 days)
Receipt No
38181
Applicant:.
Name. Fast Water Heater
Phone.
425.814.3124
Address. 12601132nd Ave NE
City' Kirkland
State: WA Zip 98034
Property I nfor.rYlCition:.
Site Address. 16136 Prairie Creek Lp
Assessor Parcel No. 69240002100
Subdivision.
Lot:
Contractor Information
Name.
Contact:
Phone:
Address
City'
State:
Zip'
Contractor License No'
Expires.
Business License:
ProjectJl1fonnCitiol1 :
Project: Conley
Description of Work: Gas Hot water tank
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
2000
700
7 0000
1 0000 Fixture
Applical1t'~ Affad,avit:
OFFICIAL USE ONLY
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.
# Sets of Prints.
Signature
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Date
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Dat : .
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Firm