20150236 Permit Pkg 06302015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: ZACARY ERKELENS
Address: 9923 COCHRANE AVE SE
YELM WA 98597
Property Information:
Site Address: QQ7-1A C_rlf_HRAM1= A\ /t= CF
Assessor Parcel No.:
Contractor Information:
Name: SOUND HEATING & AC
Address: CURTIS HOOD
5526 184TH ST. E, STE. A
PUYALLUP WA 98375
Contractor License No.: 10696
Subdivision:
Permit No.: 20150236
Issue Date: 6/30/2015
(Work must be completed within 180 days)
Phone: 785- 209 -4244
Owner: ZACARY ERKELENS
Phone:
Expires: 12/31/2015
Project Information:
Project: MECHANICAL
Description of Work: ADD ON AC TO HVAC SYSTEM
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
SOUND HEATING & AC
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 tate of VVashington. uav-114�
Signature Date
Firm
Lot:
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
N1N1 of Yell
) 456 -3244
REC #: 00199360 6/30/2015 3:02 PM
OPER: CO TERM: 001
REF #: 063950
PAID BY:
TRAN: 33.0000 BUILDING PERMITS
20150236
ERKELENS, ZACARY� 50CR
9923 COCHRANE AVE SE
MECH 29,50CR
TENDERED: 29,50 CHECK
APPLIED: 29,50-
CHANGE:
0.00
CITY OF YELM
((� ff�� RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address:"I to CCchrouu AVM Sy Parcel #:
Subdivision: Lot #: Plan #: Zoning:
❑ New Construction Re -Model / Re -Roof / Addition Home Occupation Sign
❑ Plumbing X Mechanical Mobile/ Manufactured Home Placement Other
Project Description /Scope of Work: Alc 1" ,�
on o iVVK i �*,m
Project Valuelt) � DMIN
Building Area (sq. ft) 1S' Floor 2nd Floor
Covered Patio Covered Porch
# Bedrooms_ # Bathrooms
3`d Floor Garage -2 car 3 car.
Patio Deck
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.
BUILDING OWNER NAME: ' EL
ADDRESS EMAIL 9.
CITY STATE_J)O_ZIP q,59 -1 TELEPHONE (251-1- LILIU -321-7
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 TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR bPLlt1WLt TELEPHONE - 75
ADD SSi j 111 7 l EMAIL qapdly a V116 Am
CITY 1,W :�)M STAT ZIP 5 FAX
CONTRACTOR'S LICENSE # bW EXP DATE45 CITY LICENSE # I (XO Ily
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.
Applicant's i nature Date
Owner / Con ctor / Owner's Agent / Contractor's Agent (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
105 Yelm Avenue West
Yelm, WA 98597
,ow. c i.yelm.wa. us
N 3 0 (360) 458 -3835
(360) 458 -3144 FAX
Cc;�,1 Cam -k\J7� -
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