20150302 Permit Pkg 10072015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: RICHARD /CLARICE OUKO - DAVIDSON
Address: 14922 MT VIEW CT SE
YELM WA 98597
Property Information:
Site Address: 1 AQ99 MT VIFW (:T SF
Assessor Parcel No.: 42990001600
Contractor Information:
Name: SUNSET AIR INC
Address: TERRY MEDLOCK
5210 LACEY BLVD.
LACEY WA 98503
Contractor License No.: 10734
Permit No.: 20150302
Issue Date: 10/07/2015
(Work must be completed within 180 days)
Phone: 206 - 788 -6393
Owner: RICHARD OUKO
Subdivision: COUNTY VISTA
Phone:
Expires: 12/31/2015
Project Information:
Project: MECHANICAL
Description of Work: ADD AIR CONDITIONING. DUCT LEAKAGE TEST REQUIRED
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
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 of record. If applying as a contractor, I further certify that I am currently
registered in the State of Washington. �•
Signature Date Z —j A 2--
Firm
Lot: 16
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Yell
(36 ) 458 -3244
REC #: 00209203 10/07/2015 3:31 PM
OPER: CO TERM: 001
REF #: 35072
PAID BY:
TRAN: 33.0000 BUILDING PERMITS
20150302 29.50CR
OUKO- DAVIDSON, RICHARD /CLARICE
14922 MT VIEW CT SE
MECH 29.50CR
TENDERED: 29.50 CHECK
APPLIED: 29.50-
CHANGE; 0.00
zv15d,3D2
CITY OF YELM VPJ
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: i`1 94- MUMP OW -3— 'Parcel #: ((Zq q 0 ol(vbo
Subdivision: Lot* Plan #: Zoning:
❑ New Construction ❑ Re -Model / Re -Roof I Addition D Home Occupation Sign
❑ Plumbing XMechanical ❑ Mobile / Manufactured Home Placement ❑ Other
Project Description/Scope of Work:PAf
Project Value:
Building Area (sq. ft) 1St Floor 2nd Floor 3`d Floor_
Covered Patio Covered Porch Patio
# Bedrooms
Are there any er
If yes, a comple)
ADDR
CITY
Garage -2 car 3 car
Deck
# Bathrooms_ Heating: GASIOTHER or ELECTRIC (Circle One)
nmentally sensitive areas located on the parcel?
environmental checklist must accompany permit application.
A
EMAIL
TELEPHON
CENSE #
ADDRESS / tMAIL j
CITY STATE ZIP TELEPHONE
TELEPHONE
ADDRESS_ EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # _ EXP DATE CITY LICENSE #
ADDRESS
EMAIPHONE
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
-.
TELEPHONE
ADDRESS 1 1 TRYil'oo_ - EMAIL
CITY —STATE i, ZIP FAX &go
CONT ACT 'S LICENSE #51,01 A,k EXP DAT5WITY 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.
q J1YnAAAA__Z__ —
App icant's Sigf ature Date
Owner I Contractor 1 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�perio day
SEP 18 2015
105 Yelm Avenue West (360)458 _-.J8
Yelm, WA 98597 (360) 4584144 FAX
www.ci.yelm.wa.us