20150285 Permit Pkg 09022015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: KAYHAN ZIAEE
Address: 14845 PRAIRIE VISTA LP SE
YELM WA 98597
Property Information:
Site Address: 1ARdr% 00AI W: v1¢rA 1 0 CC
Assessor Parcel No.:
Contractor Information:
Subdivision:
Name: ADVANCED FILTER AND MECHANICAL
Address:
910 VALLEY AVE NW
PUYALLUP WA 98371
Contractor License No.: ADVANFM044RD
Permit No.: 20150285
Issue Date: 9/02/2015
(Work must be completed within 180 days)
Phone: 360- 400 -1388
Owner: ZIAEE KAYHAN
Phone:
Expires: 12/29/2014
Project Information:
Project: MECHANICAL
Description of Work: INSTALL AC. DUCK LEAKAGE TEST REQUIRED
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor
MECHANICAL ADVANCED FILTER AND MECHANICAL
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 regulatio s incl ng those governing zoning and land subdivision, and in addition, all covenants.
easements a rest r cti ns of record. If applying as a contractor, I further certify that I am currently
registered in Sta e o shington.
Z Signature Date
Firm CAZ C{ 14' AA oa- A --I
c �AAn
Lot:
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Citt of Mm
(36 ) 458 -3244
REC #: 00205658 9/02/2015 10:47 AM
OPER: CO TERM: 001
REF #: 5108
PAID BY:
TRAN: 310000 BUILDING PERMITS
20150285 29.50CR
ZIAEE, KAYHAN
14845 PRAIRIE VISTA LP SE
MECH 29.50CR
TENDERED: 29.50 CHECK
APPLIED: 29.50-
CHANGE: 0.Q0
CITY OF YELM
11,,iiGGe,REESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: H` -,i(5 PMk I(� t � tan 4. Parcel #: SE � �� 1Q DID () 2_Z-D P
Subdivision: Lot #: Plan #: Zoning:
New Constructio=Mechanical' e -Model / Re -Roof / Addition Home Occupation Sign
Plumbing M_obile / Manufactured Home Placement Other
Project Description /Scope of Work: ins 3 I l W n r
Project Value:
Building Area (sq. ft) 1St Floor 2nd Floor.
Covered Patio Covered Porch
3 I Floor
Patio
Garage -2 car
Deck
3 car
# Bedrooms_ # Bathrooms_ Heating: GAS /OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel?
/f yes, a completed environmental checklist must accompany permit application.
BUILDING OWNER NAME:
ADDRESS EMAIL Rtm,!�,ph Q_56r5e7pN0hpv. tarn
CITY A? JM STATE AJA ZIP TELEPHONE - ✓i
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR h TELEPHONE2�A = �L
ADDRESSG EMAIL (
CITY V>" S ATE ZIP S FAX Z�� '1 —1
CONTRACTOR'S ICENSE #ADJ FWN< `iQEXP DATEIWLCITY LICENSE #
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTORAA iln(l - Pit t'fo+WhTELEPHONE
ADDRESSOIIU \/n t-24i >_ 1-4 V14 V- 10 ,A EMAIL jjn kt.t
CITY STATE ZIPO'�'g-11 FAX 203-
CONTRA TOR'S LICENSE # EXP DATEILCITY 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.
A <3
in Signature Date
/ Gohtractor / 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 y.
r..� i� ED
1.0 0 It 2015
105 Yelm Avenue West (360) 458 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.yelin.wa.us