20160176 Permit Pkg 03252016City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: CRISTA /CLARENC HURLING
Address: 16407 CASCADIAN AVE SE
YELM WA 98597
Property Information:
Site Address: 1AAn7 r_A -qrA IiAm AvF SF
Assessor Parcel No.: 84070001200 Subdivision:
Contractor Information:
Name: SUNSET AIR INC
Address:
5210 LACEY BLVD
LACEY WA 98503
Contractor License No.: 10734
Permit No.: 201 60176
Issue Date: 3/25/2016
(Work must be completed within 180 days)
Phone: 360- 400 -2761
Owner: CLARENCE HURLING
Phone:
Expires: 12/31/2016
Project Information:
Project: MECHANICAL
Description of Work: HEAT PUMP, GAS FURNACE REPLACEMENT. DUCT TEST REQUIRED.
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Applicants Affidavit
Contractor
SUNSET AIR INC
TOTAL FEES:
I certify t)tat 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 rvStncTi0 f record. If applying as a contractor, I further certify that I am currently
registered in the State of W shington� -,�—
Sianature 4 l "I & 1 AV' 1/ J'rSV— Date 01 'ZS - IL
Firm
Lot:
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Citt of Mm
(36 ) 458 -3244
REC #: 00226526 3/25/2016 1 :15 PM
OPER: CO TERM: 001
REF #: 35268
PAID BY:
TRAN: 33.0000 BUILDING PERMITS
20160176 29,50CR
HURLING, CRISTA /CLARENC
16407 CASCADIAN AVE SE
MECH 29.50CR
TENDERED: 29,50 CHECK
APPLIED: 29.50 -
CHANGE: 0.00
CITY OF YELM/
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: r u W7 (Z CdJ t,1q a1/—% el #: P M DOD 2go 201(01-71P
Subdivision: Lot #: Plan #: Zoning:
*4
❑ New Construction ❑ Re -Model / Re -Roof / Addition ❑ Home Occupation Sign ,
❑ Plumbing Mechanical ❑ Mobile/ Manufactured ome Placement ❑ Other
Project Description /Scope of Work: �`/
Project Value:
Building Area (sq. ft) 1St Floor 2nd Floor 3'd Floor Garage -2 car 3 car
Covered Patio Covered Porch
Patio Deck
l�
# Bedrooms_ # Bathrooms_ Heatinwdi��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.
13U L`DIN Oi NER NAME:
ADDR SS / 1, MAIL
CITY STATE ZIP TELEPHONE
,.N
AkCHITEGT ENGINEER LICENSE #
ADDRESS i EMAIL
CITY STATE ZIP TELEPHONE
00 `�RACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
PL=UMBING CQ.NTRAG_FVR TELEPHONE
ADDRESS EMAIL
CITY ST E ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MEC" -,, [ GA[. CONTRACTOR WI(-- TELEPHONE �Vt)—
ADDRESS b52 0 L-G U4 6 t Q 0 S F EMAIL
CITY SATE LJ> ZIP a3�, FAX( °�{�`lf7 —
CONTRACT R'S LICENSE #,c (,UA (,Qjj 9,4- OLOEXP DATE _ CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable.
�eout
I re certify that the above information is correct and that the construction on, and the occupancy and the use of the
bove d cribed property will be in accordance with the laws, rules and regulations of the State of Washington and the
City of )*m.
3 l yll �
Applicant's gignature 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 (360) 458 -3835
Yelm, WA 98597 BY: -- _--- - - - --- - - -- (360) 458 -3144 FAX
www.ci.yelm.wa.us