20150219 Permit Pkg 06152015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: ROBERT /CHERYL HANSEN
Address: 14833 99TH WAY SE
YELM WA 98597
Property Information:
Site Address: 1AR11 A4TH WAY SF
Permit No.: 20150219
Issue Date: -0/0111000(y �ysals� (Work must be completed wit 1 0
Phone:
Owner: ROBERT HANSEN
Assessor Parcel No.: 78640015200 Subdivision: TAHOMA MEADOW, Lot: 152
DIVISION II
Contractor Information:
Name: BOB'S HEATING & AIR
Address:
13633 NE 126TH PLACE #425
KIRKLAND WA 98034
Contractor License No.: 10102 Expires
Phone:
12/31/2015
Project Information:
Project: MECHANICAL
Description of Work: ADD AC TO EXISTING HVAC SYSTEM
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.
, l S
Signature Date 0
Firm Golf��
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cit of Mm
(36) 458 -3244
REC #: 00198359 6/15/2015 4:03 PM
OPER: CO TERM: 001
REF #: 505236
PAID BY:
TRAN: 33.0000 BUILDING PERMITS
20150219 29.50CR
HANSEN, ROBERT /CHERYL
14833 99TH WAY SE
MECH 29.50CR
TENDERED: 29.50 CHECK
APPLIED: 29.50-
CHANGE: 0,00
0610212015 TUE 22:40 FAX
Zo(S5 �A9
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 14833 99th Way SE Parcel #: 78640015200
Subdivision: Lot * _ Plan M Zoning:
❑ New Construction 0 Re -Model / Re -Roof / Addition n Home Occupation Sign
U002/002
❑ Plumbing t Mechanical ❑ Mobile / Manufactured Home Placement 0 Other
Project Description /Scope of Work: add ac to existing hvac system rJL�Cr TuT A &—Cyvf�,e-
Project Value: 6000.00
Building Area (sq. ft) 1" Floor 2rtd Floor Garage Deck
Basement Carport Patio
# Bedrooms_ # Bathrooms_ Heating,- GASIOTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel?
If yes, a completed environmental checkllat muat accompany permit application.
iFUILD (5. Ip,N±ti j0— o e ansen
ADDRESS 1483 99th W;Y= EMAIL
CITY Yelm 8TATEwa ZIP 98597 'TELEPHONE
ARCH I; �T/�}�,1N�_. LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE__
TELEPHONE
ADDRESS _ EMAIL
CITY - _ _ _ STATE ZIP FAX__
CONTRACTOR'S LICENSE #_ EXP DATA= CITY LICENSE #
M0 ,0, Y?R TELEPHONE
ADDRESS EMAIL
CITY STATE-----ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
C jrajlC NT QR Bobs ea In TELEPHONE q&R&3346
ADDRESS "14149 90th s EMAIL IJ_ 0 o s ea r1�l.com
CITY STATP- .-. M_ZIP9S072 FAX - --
CONTRACTOR'S LICENSE # 97 � EXP DATEe)3 /I,ITY LICENSE # 13- 0003s3.o
Copy of mltigatlan agreement with Yalm Community Schools, If applicable.
I hereby 0ortify that the above Information Is Correct and that the oonstructlon on, and the occupancy and the use of the
above described p5p5*k will be In accordance with the laws, rules And reguldllona of the State of Washington and the
city at Yalm, / / _ f
6/3/15
Signature Date
ttractor / Owner's Agent I Contractor's Agent (Please circle one.)
Arpermlte are non - transferable end will expire If work authorized by such permit Is not begun
within 160 drays of Issuance, or If work Is suspended or abandoned for a period of 180 days
105Ye1mAudnue Weat (bed) 48 &8898
Yetm, WA 98587 (860) 458 -8144 FAX
wram.ei.yelr».wa , us
JUN 0 3 2015
06/02/2015 TUE 22:40 FAX
Bob's Beating & Air Conditioning
14148 NE 190' St
Woodinville, WA 98072
Fax: (425) 482 -3742
Date:
Company: Bob's Heating and Air
Attn: Permits
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