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20160256 Permit Pkg 06282016City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458-3144 Applicant: Name: PATRICK VAN CLEAVE Address: 9239 BRENDAN DR SE YELM WA 98597 Property Information: Site Address: Q7'3Q RlPmunAN np SF Assessor Parcel No.: 55360002300 Subdivision: Contractor Information: Name: SUNSET AIR INC Address: 5210 LACEY BLVD. LACEY WA 98503 Contractor License No.: SUNSEAI915131 Permit No.: 20160256 Issue Date: 6/28/2016 (Work must be completed within 180 days) Phone: Owner: PAT VAN CLEAVE Phone: Expires: 1/21/2017 Lot: Project Information: Project: MECHANICAL Description of Work: REPLACE GAS FURNACE AND AIR CONDITIONER. DUCT 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 St at ' "of Washington. Signature Date / Firm Fees $ 29.50 $ 29.50 OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: Cite of Mm (361) 458 -3244 RECA': 00235595 6/28/2016 11:49 AM OPER: CO TERM: 001 REFS': 35363 PAID BY: TRAM: 33.0000 BUILDING PERMITS 20160227 29.50CR WADLEIGH, STEVE / LEA -ANN 9307 PRAIRIE WIND MECH 29.50CR TRAM: 33.0000 BUILDING PERMITS 20160232 29.50CR MASON, ANTHONY 14871 89TH AVE SE MECH 29.50CR TRAM: 33.0000 BUILDING PERMITS 20160257 29.50CR HUDNELL, COLTEN & JENNIF 9870 JENSEN DR SE MECH 29.50CR TRAM: 33.0000 BUILDING PERMITS 20160256 29.50CR VAN CLEAVE, PATRICV. 9239 BRENDAN DR SE MECH 29.50CR TENDERED: 118.00 CHECK APPLIED: 118.00- CHANGE: 0.00 CITY OF YELM :�o'vsIS RESIDENTIAL BUILDING PERMIT APPLICATION FORM Project Address: q� � q V( ,ItlU alai 06_ Parcel #: Subdivision: Lot #: Plan #: Zoning: ❑ New Construction ❑ Re -Model / Re -Roof / Addition ❑ Home Occupation Sign ❑ Plumbing Mechanical r,, ❑n Mobile / Manufactured Home �Placement ,�J I-�❑ Other Project Descriptio /nlScope of Work: CSI tq� �� Cur ��'��-tu' I O Y �. (, (Qr, Project Value: Cp s JL C �.� A e c Building Area (sq. ft) 13t Floor 2nd Floor 3d Floor_ Covered Patio Covered Porch Patio Garage -2 car 3 car Deck # Bedrooms! # Bathrooms— Heating: GAS /OTHER or ELECTRIC (Circle One) Are there any environmentaily sensitive areas located on the parcel? If yes, a completed environmental checklist must accompany permit application. VowC ADDRESS t,I`l EMAIL CITY P IVY? STATE I,JG1 ZIP TELEPHONE LICENSE # ADDRESS EMAIL CITY STATE ZIP TELEPHONE _ TELEPHONE ADDRESS EMAIL CITY S TE ZIP FAX CONTRACTOR'S LICENSE EXP DATE CITY LICENSE # �� _._ - ELEPHONE ADDRESS TEMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE —CITY LICENSE # =..RN L)A5r JnI tidfJt.i TELEPHONE 71PU "i�12 "`'I''I�(� ADDRESS U 5 _ EMAIL 4�ivY1 t�_ ,q,111,5 CITY S ATE�ZIP Q,j�03 FAX CONTRAC R'S LICENSE #SJ c "" aJaL0QXP DATE _CITY LICENSE # "514-1 (i"i Copy of mitigation agreement with Yelm Community Schools, if applicable. hereby certify that the above Information Is correct and that the construction on, and the occupancy and the use of the above deWlixd property will be in accordance with the laws, rules and regulations of the State of Washington and the City of X61 m. Applicants Signature Date Owner / Contractor / Owner's Agent 1 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 da s o�c m 105 Yelm Avenue West (360) 4 5 Yelm, WA 38597 (360) 4 -3 JTVXT`� '—' - - - wwwA.yelm, w a. us