20150214 Permit Pkg 06022015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: YELM CO -OP
Address: PO BOX 75301
YELM WA 98597
Property Information:
Site Address: znR vGl nn A1100
Assessor Parcel No.: 99000114600 Subdivision:
Contractor Information:
Name: TOP NOTCH PLUMBING INC
Address:
P.O. BOX 947
RAINER WA 98576
Contractor License No.: 10778
Permit No.: 20150214
Issue Date: 6/02/2015
(Work must be completed within 180 days)
Phone: 360 - 400 -2210
Owner: YELM FOOD COOPFRATIVF
Phone:
Expires: 12/31/2015
Project Information:
Project: PLUMBING
Description of Work: INSTALL PRODUCE MISITN SYSTEM W RPBA
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
PLUMBING
Contractor
TOP NOTCH PLUMBING INC
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 the State of Was ing
Signature Date
Firm
Lot:
Fees
$ 27.00
$ 27.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Mm
(36 ) 458 -3244
REC #: 00196647 6/02/2015 3:30 PM
OPER: CO TERM: 001
REF #: 13604
PAID BY:
IRAN: 33.0000 BUILDING PERMITS
20150214 27.000R
YELM CO -OP
308 YELM AVE E
PL 27.000R
TENDERED: 27.00 CHECK
APPLIED: 27.00 -
CHANGE: 0.00
-#,)7,. o0
CITY OF YELM
COMMERCIAL BB' UILDING PERMIT APPLICATION FORM
Project Address: .� U %P i1T', r"l G /e- Parcel #:
Zoning; C -6 Current User' fo. ( Proposed Use:_
New Construction Re -Model / Re -Roof / Tenant Improvement
Plumbing Mechanical Fire Prevent/Suppress /Alarm Other
Project Description /Scope of Work: _j��n sfia I( J,�'o d u G�
Project Value:
Building Area (sq. ft) Parking Garage 1" Floor Z.sf't"�nd Floor 3rd Floor
Building Height /S� s 1
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER/TENANT NAME: eln
ADDRESS 30'75 y (rrl ��fenv EMAIL
CITY Xe lm STATE_ ,/ A ZIP TELEPHO E_ _ {;
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
PLUMBING CONTRACTOR o i, Aln-fcA fruln bins TELEPHONE ,3rQ - yy 6 e 03
ADDRESS 3 3 $ c s EMAIL
CITY STATE WA ZIP 7 S57 7 FAX
CONTRACTOR'S LICENSE # TEFt,p _r78V K EXP DATE iY ITY LICENSE #
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
Copy of City Mitigation documentation (TFC).
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.
2-11
Applicant's Tignature Date
Owner / Contractor / Owner's Agent / Contractor's Agent (Tenant)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
(360) 458 -3835
105 Yelm Ave W (360) 458 -3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us