20160269 Permit Pkg 06242016City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: BRANDON RIES
Address: 9980 JENSEN DR SE
YELM WA 98597
Property Information:
Site Address: 9980 JENSEN DR SE
Assessor Parcel No.: 78640105600
Contractor Information:
Name: A PLUS SERVICES
Address:
7225 PACIFIC AVE SE
OLYPIA WA 98503
Contractor License No.: ALECS'994NO
Project Information:
Project: MECHANICAL
Description of Work: INSTALL AC AND COIL
Sq. Ft. per floor:
First
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Subdivision
Permit No.: 201 60269
Issue Date: 6/2412016
(Work must be completed within 180 days)
Phone: 910- 546 -0666
Owner: BRANDON RIES
TAHOMA TERRA Lot: 56
Phone:
Expires: 8/29/2017
Heat Type (Electric, Gas, Other):
Contractor
A PLUS SERVICES
TOTAL FEES
Applicant's Affidavit:
I certi� that I hpe read and examined the information contained within the application and know the same
to beltrue and c rect. I also certify that the proposed structure is in conformity with all applicable City of
Yelm ^regulation i cluding those governing zoning and land subdivision, and in addition, all covenants,
easements an restrictions of record. If applying as a contractor, I further certify that I am currently
registered in th tote of shington.
Signa re )1AA Date Z
Firmj��(y Cp�O
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of Yolm
(36 1) 458 -3244
* * * ** R E P R I N T R E C E I P T * * * **
RECA': 00235481 6/24/2016 2:42 PM
OPER: CO TERM: 001
REF #: 35414
PAID BY:
TRAM: 33.0000 BUILDING PERMITS
20160269 29.50CR
RIES, BRANDON
9980 JENSEN DR SE
TENDERED: 29.50 CHECK
APPLIED: 29.50-
CHANGE: 0.00
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: Y 7 % U 3EN5E4 DR SE Parcel #: 7 $G y0 / O5ly G O
Subdivision:
Lot #: Plan #: Zoning:
Z01A o2�,7
❑ New Construction I i Re -Model / Re -Roof / Addition I I Home Occupation Sign
Plumbing h%Mechanical I I Mobile / Manufactured Home Placement I Other
Project Description /Scope of Work: t.,s}-AP AC cod
Project Value: $IY600
Building Area (sq. ft) 1s' Floor 2nd Floor 3rd Floor Garage -2 car 3 car
Covered Patio Covered Porch Patio Deck
# Bedrooms_ # Bathrooms_ Heating: GAS /OTHER o (ELECTRIC Circle One)
Are there any environmentally sensitive areas located on the parcel?
If yes, a completed environmental checklist must accompany permit application.
BUILDING OWNER NAME: SRANIMAI 4- KAree R tes
ADDRESS 99Sr0 TEnISEn/ OR sr EMAIL
CITY YEI-M STATE WA `j$Sr/'}- TELEPHONE
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 Af Services TELEPHONE 3to - f 2400
ADDRESS 7z2S 'PAcIPIC Ave SF- EMAIL _mle 16'.b1ea.rrt"
CITY Vit-YMP IA STATE WA ZIP 91503 FAX 36o - Ct -/990
CONTRACTOR'S LICENSE #a-EC5*91Y1yo EXP DATEVaCITY LICENSE #_a0o /Z.
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 described property will be in accordance with the laws, rules and regulations of the State of Washington and the
City of Yelm.
Applicant's Signature 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 (360) 458 -3144 FAX
www.ci.yelm.wa.us