20150270 Permit Pkg 08122015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20150270
Issue Date: 8/12/2015
(Work must be completed within 180 days)
Applicant:
Name: BETTY J. STANTON Phone: 360- 458 -8951
Address: 14905 PRAIRIE VISTA LP
YELM WA 98597
Property Information:
Site Address: 14905 PRAIRIE VISTA LP SE Owner: BETTY STANTON
Assessor Parcel No.:
Subdivision:
Contractor Information:
Name: SUNSET AIR INC
Phone:
Address: TERRY MEDLOCK
5210 LACEY BLVD.
LACEY WA 98503
Contractor License No.: 10734
Expires: 12/31/2015
Project Information:
Project: MECHANICAL
Description of Work: ADD AIR CONDITIONING.
DUCT TEST REQUIRED
Sq. Ft. per floor:
Heat Type (Electric, Gas, Other):
First
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
SUNSET AIR 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 record. If applying as a contractor, I further certify that I am currently
registered in the St hington.
Signature Date
Firm ffm4se° - /t,f
Lot:
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Yelm
(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. 003/004
___1 2X*57o29&
vviv CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATIION FORM
Project Address: lu d J p(/j Oj- V6/ -kW SE-Parcel #. O (R M QQ1
Subdivision:
Lot #: Plan #: Zoning:
❑ New Construction iJ Re -Model / Re -Roof / Addition ❑ Home Occupation Sign
0 Plumbing q(Mechanical ❑ Mobile I Manufactured Home Placement ❑ Other
Project Dos cription /S cope of~�Work: 0-ft-cur aO
Project Value; 15'W
t ]
Building Area (sq. ft) 181 Floor 2nd Floor 31d 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?
ff yes, a completed environmental checklist must accompany permit application.
.�Iaia rv3i�la!�,A??r a +��� ►. /.� ill
LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
TELEP
CITY 9TATE_k2A_ZIP %n _F
CONT ACT 'S LICENSE # XPDATE CITY LICENSE
" ____TELEPHONE_
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LIC
TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LIC
Copy of mitigation agreement with Yelm Community Schools, if applicable.
I -hern�,,sad tFiat the atiove information iscorrect and -Ehai t e> tructlon on— andihe occiiparicy and the use of he
abov property will be in accordance with the laws, rules and regulations of the State of Washington and the
City
Applicant's Signature Date
Owner 1 Contractor I Owner's Agent I 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
t
105 Yelm Auenue West ` (360) X158 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.yelm, wa, ics