20150230 Permit Pkg 06292015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20150230
Issue Date: 6/29/2015
(Work must be completed within 180 days)
Applicant:
Name JIM & JENNIFER CAREY Phone: 253 - 405 -1424
Address: 9951 GREENLEAF CT SE
YELM WA 98597
Property Information:
Site Address: 9951 GREENLEAF CT SE Owner: JIM CAREY
Assessor Parcel No.: 84070011900 Subdivision: WILLOW GLENN III
Contractor Information:
Name: FURNACE DOCTORS Phone:
Address:
PO BOX 59717
RENTON WA 98058
Contractor License No.: FURNAD1931QL Expires: 11/13/2015
Project Information:
Project: MECHANICAL
Description of Work: INSTALLATION OF AC UNITS. DUCT TEST IS REQUIRED.
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
FURNACE DOCTORS
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 to?-,
governing zoning and land subdivision, and in addition, all covenants,
easements and restrictions of record. If applyjng as a contractor, I further certify that I am currently
registered in the State of Wasbi�
Sianature / / /; - Date /� l
Firm G�
Lot: 119
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Yolm
(36 ) 458 -3244
REC #: 00199292 6/29/2015 3 :49 PM
OPER: CO TERM: 001
REF #:
PAID BY:
ACCT #: XXXXXXXXXXXXXXXXXXX
RUTH #: 174695
TRAN #: 000000002145
TRAN: 30.0000 BUSINESS LICENSE
FURNACE DOCTORS
BUSINESS LICENSES & 35.00CR
TRAN: 33.0000 BUILDING PERMITS
20150230 29.50CR
CAREY, JIM & JENNIFER
9951 GREENLEAF CT SE
MECH 29.50CR
TENDERED: 64.50 CREDIT CARD
APPLIED: 64.50-
CHANGE: 0.00
Jun 29 1510:57a Furnace Doctors, Inc.
08/29/2015 HON 11:32 PAX
425- 743 -0662 p.2
Idool/002
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
r Protect Address +' � 5 t � rKf ?it t't -P ,. Parcel #:
`��-cl -
Zoning; Current Use: Proposed Use:
ti
0 New Construq'on 0 Re-Model? Re -Roof 1 Tenant Improvement
0 Plumbing Mechanical 0 Fire PreventiSuppressfAlarm ❑ Other
Project DescriptlonfScope of Work:
Project Value: -�-10-0
Building Area (sq. ft) Parking Garage l* Floor 2"° Floor 3' Floor
Building Height
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
BCtt oit#3 O ERFTENAWr CYpiME:
ADDRESS Ci EMAIL
CITY-147-1. TATE ZIP TELEPHONE
NE
ADDRESS,
CITY
AT
LICENSE #
EMAIL ____
TELEPHON
GENERRL-CONTRA07011 —TELEPHONE
ADDRESS EMAIL
CITY STAIR ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #_
PLUMBING CONTRA.CtOR TELEPHONE
ADDRESS —EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
NjECNpiV.1CA;'CONTRAGTi7F��uW. &C& tom_ rkfii TELEPHONE DO (fa�'�1T%ir�l R
ADDRESS � m> . n EMAIL
CITY R911 = —STATEVJA ZIP FAX 2K t2Q Iry
CONTRACTOR'S LICENSE # = .? ' - EXP DATE —CITY LICENSE #
Copy of City Mlttgatton documentation (TFC). ,
b)rr+ilve d�c4vrstr� c col •�
I hereby cordy that the above Information Is correct and that the construction on, and the occupancy and the use of the
above deecrlbed property will be In accordance with the laws, rules and reg4lattons of the State of Washington and the
City of Yeim.
Applicant Sign- ture Date
Owner i Contractor I Own Agent/ Contractor's Agent I Tenant (Please circle one.)
All permits are non - transferable and will expire If work authorized by such permit Is not begun
within 160 days of lasuanco, or if work is suspended or abandoned for a period of 160 days
106 Yeim. Ave W
Yeim, WA 98597
(8eo) 458 -sass
(8B0) 458 -8144 PAX
WWW.ciyeim.rua,w
Ejutnr 11w1w.11 11.,lwnul Contact Search L &I
1 -1 iru €cx 11,11) M1 Sci'ttrt, L&I
Safety Claln7s & Insurance VAdorkplace Rights Trades & Licensing
10 Washington State Department of
Labor & Industries
FURNACE DOCTORS INC
Owner or tradesperson PO BOX 59717
RENTON, WA 98058
Principals 206- 622 -5018
Day, Johnathan Timothy, PRESIDENT KING County
Day, Geraldine Suzanne, VICE PRESIDENT
Day, Johnathan Timothy, AGENT
Doing business as
FURNACE DOCTORS INC
WA UBI No.
Business type
602 682 733
Corporation
Governing persons
GERALDINE
SUZANNE
DAY
JOHNATHAN TIMOTHY DAY;
License
Verify the contractor's active registration / license / certification (depending on trade) and any past violations.
Construction Contractor
Active.
Meets current requirements.
License specialties
Heating /Vent/Air- Conditioning and Refrig
(HVAC /R)
License no.
FURNADIS31 QL
Effective — expiration
11/13/2007— 11/13/2015
Bond
Wesco Insurance Co $6,000.00
Bond account no.
46WBO56713
Received by L &I Effective date
11/14/2014 11/14/2014
Expiration date
Until Canceled
Bond history
Insurance
Ohio Security Ins Co $1,000,000.00
Policy no.
BKS5582135
Received by L &I Effective date
05114/2015 05/01/2015
Expiration date
Insurance history
Savings
No savings accounts during the previous 6 year period.
Lawsuits against the bond or savings
_ 1111. .
Cause no.
10- 2- 28644 -6SEA
Complaint filed by
DEPT OF LABOR & INDUSTRIES
Complaint date
08/09/2010
05/01/2016
Dismissed
Complaint against bond(s) or savings
41090013
Complaint amount
$1,773.64
L &I Tax debts
No L &I tax debts are recorded for this contractor license during the previous 6 year period, but some debts
may be recorded by other agencies.
License Violations
No license violations during the previous 6 year period.
Workers' comp
Do you know if the business has employees? If so, verify the business is up -to -date on workers' comp premiums
L &I Account ID Account is current.
539,381-04
. ........1.111 ..................
Doing business as
FURNACE DOCTORS
Estimated workers reported
Quarter 1 of Year 2015 " 1 to 3 Workers"
L &I account representative
T1 / NICHOLE CAROW (360)902 -5634 - Email: CANI235@lni.wa.gov
Workplace safety and health
No inspections during the previous 6 year period.
C) Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington.