20150344 Permit Pkg 12172015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: ORALIA LAD
Address: 14827 PRAIRIE VISTA LP
YELM WA 98597
Property Information:
Site Address: 1AR77 PPAIF?IF VISTA I P CF
Assessor Parcel No.:
Contractor Information:
Name: ORALIA LAD
Address:
14827 PRAIRIE VISTA LP
YELM WA 98597
Contractor License No.:
Subdivision:
Permit No.: 20150344
Issue Date: 12/1712015
(Work must be completed within 180 days)
Phone:
Owner: EDWARD LAD
Phone:
Expires: 0 /00 /0000
Project Information:
Project: MECHANICAL
Description of Work: REPLACE HOT WATER HEATER WITH SAME
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
PRATTS PLUMBING
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 f Washingt n,
t �-
Signature Date la't
Firm 1/ /0 I U I I I.. I/Ana_/
Lot:
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Yelm
(36 ) 458 -3244
REC #: 00216666 12/18/2015 10:01 AM
OPER: CO TERM: 001
REF #: 7131
PAID BY:
TRAN: 33.0000 BUILDING PERMITS
20150344 29.50CR
LAD, ORALIA
14827 PRAIRIE VISTA LP SE
MECH 29.50CR
TENDERED: 29.50 CHECK
APPLIED: 29.50 -
CHANGE: 0.00
201 � -3qq
CITY OF YELM
RESIDENTIAL BUILDI NG PERMIT APPLICATION /FORM /Ir
Project Address:jW7 xll-/ e_ Vl5T7 ,�p
Parcel #:
Subdivision: Lot #: Plan #: Zoning:
New Construction Re -Model / Re -Roof / Addition E Home Occupation Sign
Plumbing I/ Mechanical I Mobile / Manufactured Home Placement Other
Project Description /Scope of Work: �%°� L%D)r�.t-
Project Value:
Building Area (sq. ft) 1St Floor 2nd Floor —3 rd 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?
If yes, a completed environmental checklist must accompany permit application.
' 12201110JR1111 � G 6
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 CONTRACTOR ELEPHON
ADDRESS " Q �P — EMAIL
CITY QIVAnViR STATE ZIP FAX
CONTRA TO 'S LICENSE # EXP DATE CENSE #
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.
Applicant' nature 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
105 Yelm Avenue West
Yelm, WA 98597
___ ci yelm. wa. us
(360) 458 -3835
X360) 158-3149 fig