20150265 Permit Pkg 08122015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: JASON & MICHELL DAVIS
Address: 9337 PRAIRIE WIND ST SE
YELM WA 98597
Property Information:
Site Address: Q117 PRAIRIE wimn ST 4F
Assessor Parcel No.: 64410001400
Contractor Information:
Name: SUNSET AIR INC
Address: TERRY MEDLOCK
5210 LACEY BLVD.
LACEY WA 98503
Contractor License No.: 10734
Permit No.: 20150265
Issue Date: 8/12/2015
(Work must be completed within 180 days)
Phone: 912- 223 -5172
Owner: JASON DAVIS
Subdivision: MCKENZIE MEADOWS Lot: 14
Phone:
Expires: 12/31/2015
Project Information:
Project: MECHANICAL
Description of Work: ADD AIR CONDITIONING. DUCT TEST REQUIRED
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
SUNSET AIR INC
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 restrict s of record. If applying as a contractor, I further certify that I am currently
registered in the a Washington.
Signature Date ZIA�15
Firm _SM45e-f Air
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of felm
(36 ) 458 -3244
REC #: 00203972 8/12/2015 12 :51 PM
OPER: CO TERM: 001
REF #: 35005
PAID BY:
IRAN: 33.0000 BUILDING PERMITS
20150265 29.50CR
DAVIS, JASON & MICHELL
9337 PRAIRIE WIND ST SE
MECH 29.50CR
TRAN: 33.0000 BUILDING PERMITS
20150270 29.50CR
STANTON, BETTY J.
14905 PRAIRIE VISTA LP SE
MECH 29.50CR
TRAN: 33.0000 BUILDING PERMITS
20150266 29.50CR
MOXLEY, JIMMY /LESLIE
9877 DOTSON ST SE
MECH 29.50CR
TENDERED: 88.50 CHECK
APPLIED: 88.50-
CHANGE: 0.00
1UL /20/2015/MON 12:45 PM Sunset Air FAX No. 360 456 4990 P. 00 AU -
. O PIA 2otso'-a�ls
CITY OF YELM
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RESIDENTIAL BUILDING PERMIT APPLICATION FORM
iFOp�,R1�M t,
Project Address: ��l � r �roArl. -- will V+ Parcel #: ��-[�^t 1 VU b I `7 O
Subdivision: Lot #:_ Plan #- Zoning:
❑ New Construction G Re -Model / Re -Roof / Addition D Home Occupation Sign
❑ Plumbing Mechanical ❑ Mobile / Manufactured Home Placement 0 Other
Project Description /Scope of Work :
Project Value:
Building Area (sq, ft) Ig" Floor 2 "0 Floor 3`d Floor Garage -2 car 3 car,
Covered Patio Covered Porch Patio Deck_
# 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.
1.11-
EMAIL
TELEPHONE
LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHON
_ I& nZa i A iiAr Ar , IN / TELEPHON
CITY, �IQ STATE �dI- -ZIP tiXlly� �I�X
CONTRAGJT R'S LICENSE #,gLAAeLJ4 ' DLiA- EXP DATE CITY LICENSE
TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE #_ EXP DATE CITY LICENSE #
TELEPHONE
ADDRESS EMAIL.
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yeim Community Schools, if applicable.
e.
.... _.
- - -- - -'l herea certIf y] "th4f -f a atiov® 1iiformafiofi is correcf
—and 'that t e construction on, and
-the occupancy aril tfie use of the
abov, des ribed property will be In accordance with the laws, rules and regulations of the State of Washington and the
Git of Yel
Applicant's Signature Date
Owner l 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 Avenue West
Yelm, WA 98597
www.ci.yelm.wa.tcs
(360) 958 -3835
(360) 458 -3144 FAX