20150294 Permit Pkg 09112015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20150294
Issue Date: 9111/2015
(Work must be completed within 180 days)
Applicant:
Name ANACLETO ZAMORA Phone: 360- 400 -0661
Address: 14947 99TH AVE SE
YELM WA 98597
Property Information:
Site Address: 14947 99TH AVE SE Owner: ANACLETO ZAMORA
Assessor Parcel No.: 78640006700 Subdivision: TAHOMA TERRA Lot: 67
Contractor Information:
Name: WESCO Phone: 206 - 378 -2033
Address:
2800 THORNDYKE AVENUE WEST
SEATTLE WA 98199
Contractor License No.: WASHIES9710B000 Expires.
Project Information:
Project: MECHANICAL
Description of Work: REPLACE GAS WATER HEATER
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor
MECHANICAL WESCO
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 orrect. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regulati those governing zoning and land subdivision, and in addition, all covenants,
easements a d r trictions f record. If applyi g as a contractor, I further certify that I am currently
registered in the tate of Wa hington.
Signature Date I '
Firm I it - ro
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 14947 99th Ave SE
Subdivision:
Parcel #: 78640006700
Lot #: Zoning-,
�MG ova y
New Construction vf' Re -Model / Re -Roof / Addition 7 Home Occupation Sign
_i Plumbing Mechanical Mobile / Manufactured Home Placement 1-1, Other
Project Description /Scope of Work:
Project Value: $1483.45
REPLACE GAS WATER HEATER
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: AnacletoZamora
ADDRESS 14947 99th Ave SE EMAIL
CITY YELM STATE WA ZIP 98597 TELEPHONE 3106143126
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR WESCO TELEPHONE 800- 398 -4663
ADDRESS 3909196thStsW EMAIL
CITY lynnwood STATE WA ZIP 98036 FAX
CONTRACTOR'S LICENSE # WASHIES9710B EXP DATE 9/15 CITY LICENSE # 30501
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.
1 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.
N, - S-ll g1zJs,—
Applicant's 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
SEP 0 9 2015
105 Yelm Avenue West � (360) 458 -3835
PO Box 479 360 458 -3144 FAX
--_ _ ( )
Yelm, WA 98597 www.ci.yelm.wa.us
City of Mi
(36 } 458 -3244
REC #: 00206703 9/1112015 1:20 PM
OPER: CO TERM: 001
REF #: 2395
PAID BY:
IRAN: 310000 BUILDING PERMITS
20150294 29.50CR
ZAMORA, ANACLETO
14947 99TH AVE SE
MECH 29.50CR
TENDERED: 29.50 CHECK
APPLIED: 29.50-
CHANGE: 0,00
Northwest Permit Inc.
C P r T,, c c m
Please find enclosed a permit application and check for the site address
below, please process and mail permits to:
Northwest Permit
9808 31s' Ave S.E.
Everett, WA. 98208
SITE ADDRESS: 14947 99th Ave SE
AMOUNT: $29.50
Also, if you could please update your records with our new mailing
address listed above; and if you have any questions or concerns please
contact Dy Sconzo of Northwest Permit at (360)945 -2787.
9808 31st Ave S.E. Everett, WA. 98208
Phone: (360) 945 -2787 • Fax: (888) 400 -0383 • www.nwpermit.com