20150282 Permit Pkg 08272015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: WILLIAM & MICHE O'KEEFE
Address: 15417 91 ST AVE SE
YELM WA 98597
Property Information:
Site Address: 15417 91ST AVE SE
Assessor Parcel No.: 41610016800
Contractor Information:
Name: WILLIAM & MICHE O'KEEFE
Address:
15417 91 ST AVE SE
YELM WA 98597
Contractor License No.:
Project Information:
Project: MECHANICAL
Description of Work: INSTALL AC
Sq. Ft. per floor: F.
first
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Subdivision
Permit No.: 20150282
Issue Date: 8/27/2015
(Work must be completed within 180 days)
Phone: 480 - 558 -6156
Owner: WILLIAM O'KEEFE
CHERRY MEADOWS Lot: 168
Expires:
Phone:
0 /00 /0000
Heat Type (Electric, Gas, Other):
Contractor
WILLIAM & MICHE O'KEEFE
TOTAL FEES:
Applicant's Affidavit:
I certify that I have read and ex ined the information contained within the application and know the same
to be true and correct. I also ce ify that the proposed structure is in conformity with all applicable City of
Yelm regulations includijtg those governing zoning and land subdivision, and in addition, all covenants,
easements a4restrictibns of recbfd If . a pplyi as a contractor, I further certify that I am currently
registered in tKe State f '2shington.
l
Signature , Date ;
Firm
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Citj of Yelm
(36 ) 458 -3244
REC #: 00205381 812712015
OPER: CO TERM: 001 1:59 PM
REF #: 6192
PAID BY:
IRAN: 33.0000 BUILDING PERMITS
20150282
O'KEEFE 29.50CR
15417 91STIAVEASE& MICNE
MECH 29.50CR
TRAN: 30.0000 BUSINESS LICENSE
NB GREEN CITY HVAC
BUSINESS LICENSES & 35.000R
TENDERED: 64.50 CHECK.
APPLIED: 64.50-
CHANGE: p0 0
CITY OF YELM 5do�
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: /54/7- 9l y ave s c Parcel #: 4110 /d D / & 8 U D
Subdivision:
Lot #: Plan #: Zoning:
New Construction Re -Model / Re -Roof / Addition Home Occupation Sign
Plumbing Mechanical Mobile/ Manufactured Home Placement Other
Project Description /Scope of Work: I hSSG 11 Ac
Project Value: 9 -72S4.O0
Building Area (sq. ft) 1s' Floor 2nd Floor 3`d Floor_
Covered Patio Covered Porch Patio
Garage -2 car 3 car.
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.
BUILDING OWNER NAME: j i It i v\ ec c✓
ADDRESS I54I -1, GI St Ave_ Sf- EMAIL C.Ur��nrl hvCtC @ 4matl•cv►ryt,
CITYYeIrv\ STATEUIA_ZIPCN5_ i-7 TELEP NE 20(o Z2"7- (,1A �
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 CONTRACTORCIre6n NVAC TELEPHONE J01g • a07- (o Lol i�
ADDRESS 19131 • ST E I EMAIL C'recnc 4hva r P oA40 J l C_0'"
CITY a, STATEIJ/t ZIP9P3Gi/ FAX
CONTRAC OR'S LICENSE #(5k6MCH9b&8Z EXP DATEI' ITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable.
I hereby certity ha : ab've information is correct and that the construction on, and the occupancy and the use of the
above describe �1{ro1hp ill be in accordance with the laws, rules and regulations of the State of Washington and the
City of Yelm.
L-?� S1161i5
Applica ' ignatu Date
Owner ontractor / 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 (360) 458 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
wwto.ci.yelm.wa.us
8120/2015
91stAVE SE
Electrical Panel
200AMP
Homel -ine
Property
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XC17- 036 -230
Air Conditioner
Compressor Unit
To Be Installed
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