20150258 Permit Pkg 07212015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: SHERIHAUGEN
Address: PO BOX 33807
FT LEWIS WA 98433
Property Information:
Site Address: QRSR r.PFFNI FAF I P SF
Assessor Parcel No.: 64421400400 Subdivision
Contractor Information:
Name: CAPITAL HEATING AND COOLING
Address:
1218 CARPENTER RD
LACEY WA 98503
Contractor License No.: CAPITHC948N3
Permit No.: 20150258
Issue Date: 7/21/2015
(Work must be completed within 180 days)
Phone: 253 - 477 -0244
Owner: SHERI HAUGAN
N/A Lot:
Phone:
Expires
9/08/2013
Project Information:
Project: MECHANICAL
Description of Work: REPLACE 3 TON GAS FURNACE AND INSTALL A 2.5 TON HEAT PUMP. DUCT LEAKAGE
TEST REQUIRED.
Sq. Ft. per floor: First
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Heat Type (Electric, Gas, Other):
Contractor
CAPITAL HEATING AND COOLING
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 Washin tom / l
Signature C �/ Date, 21 �2v16
Firm
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Mm
(36 ) 458 -3244
REC #: 00201960 7/21/2015 3 :47 PM
OPER: CO TERM: 001
REF #: 9926
PAID BY:
IRAN: 33.0000 BUILDING PERMITS
20150258 29.50CR
HAUGEN, SHERI
9856 GREENLEAF LP SE
MECH 29.50CR
TENDERED: 29.50 CHECK
APPLIED: 29.50 -
CHANGE: 0.00
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 9856 Greenleaf Ip SE Parcel #: 84070005100
Subdivision: Lot #:
Zoning-,
New Construction / Re -Model / Re -Roof / Addition Home Occupation Sign
Plumbing /Mechanical Mobile / Manufactured Home Placement Other
Project Description /Scope of Work: Replace 3 ton gas furnace and installing a 2.5 ton heat pump
Project Value: 9000
Building Area (sq. ft) 1St Floor 2nd Floor Garage Deck
Basement Carport Patio
# Bedrooms_ # Bathrooms_ 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: Sheri Haugan
ADDRESS PO BOX 33807 EMAIL
CITY Ft Lewis STATE wa ZIP 98433 TELEPHONE 360 -888 -9138
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR Capital Heating and Cooling TELEPHONE 360- 491 -7450
ADDRESS 1218 Carpenter Rd EMAIL
CITY Lacey STATE WA ZIP 98503 FAX
CONTRACTOR'S LICENSE # CAPITHC948N3 EXP DATE9i16 CITY LICENSE # 525291
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
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.
Digitally signed by Kathleen Genge
Kathleen Genge DN il-"t .,p Genge, o= Northwest Permit Inc ou.
mail= ka[ @nwpe-nit ,m, 14-
Date: 2015.07 . 1616.53:39 - 07'00'
Applicant's Signature Date
Owner / Contractor / 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 Auenue West (360) 458 -3835
PO Box 479 (360) 458 -3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us
Karen Bennett
From: Kathleen Genge [kat @nwpermit.com]
Sent: Tuesday, July 14, 2015 4:57 PM
To: Karen Bennett
Cc: Naida Khan
Subject: Mechanical Application
Attachments: Capital Yelm Haugan 9856 Greenleaf Ip SE.pdf
Karen,
I have attached a mechanical permit. Please advise if you require more information. If not could you please
advise when this is ready?
I signed this application as I am an authorized agent for Capital Heating and Cooling.
Thank you,
Kathleen
Kathleen Genge
Northwest Permit Inc.
Direct: 206 - 212 -0009
NORTHWEST PERMIT INC - Permits In line, On line, In time. Since 1985
Main: (36o) 945 -2787 - Fax: (888) 400 -0383 - www.nwpermit.com
al soas8
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 210 S SAVE NE Parcel #: 64421400400
Subdivision: Lo Zoning-,
New Construction ✓ Re -Model / Re -Roof / Addition Home Occupation Sign
Plumbing V Mechanical Mobile / Manufactured Home Placement Other
Project Description /Scope of Work: Replace 3 ton gas furnace and installing a 2.5 ton heat pump
Project Value: 9000 F 'v � 'r �JT t
Building Area (sq. ft) 1st Floor
Basement
2nd Floor Garage Deck
Carport Patio
# Bedrooms_ # Bathrooms_ 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: Sheri Haugan
ADDRESS PO BOX 33807 EMAIL
CITY Ft Lewis STATE Wa ZIP 98433 TELEPHONE 360 -888 -9138
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
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.
Digitally signed by Kathleen Genge
Kathleen Gen e Dm <n= KathleenGi,.e..,f —O, wes[Permi[Inc,ou.
ail= kat @nwpermitcom. c =US
Date: 101111 1111:11:19 -01W
Applicant's Signature Date
Owner / Contractor / 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
i
JUL 15 2015
105 Yelm Auenue West (360) 458 -3835
PO Box 479 (360) 458 -3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us
Karen Bennett
From:
Sent:
To:
Subject:
Attachments
Kathleen Genge
Northwest Permit Inc.
Direct: 206 -212 -0009
Kathleen Genge [kat @nwpermit.com]
Friday, July 17, 2015 11:33 AM
Karen Bennett
Capital application for 9856 Greenleaf Ip SE
Capital Yelm Haugan 9856 Greenleaf Ip SE.pdf
NORTHWEST PERMrr INC - Permits In line, On line, In time. Since 1985
Main: (360) 945 -2787 - Fax: (888) 400 -0383 - www.nwpermit.com