20160226 Permit Pkg 06032016City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: PHYLLIS KRUEGER
Address: 14915 PRAIRIE VISTA LP
YELM WA 98597
Property Information:
Site Address: 14915 PRAIRIE VISTA LP SE
Assessor Parcel No.:
Contractor Information:
Name: FAST WATER HEATER
Address:
11715 NORTH CREEK PARKWAY S.
BOTHELL WA 98011
Contractor License No.: FASTWWH948BC
Subdivision:
Expires:
Permit No.: 20160226
Issue Date: 6/03/2016
(Work must be completed within 180 days)
Phone:
Owner: PHYLLIS KRUEGER
Lot:
Phone: 425 - 814 -3124
1/04/2017
Project Information:
Project: MECHANICAL
Description of Work: REMOVE AND REPLACE GAS WATER HEATER
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
FAST WATER HEATER
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 d c o certify that the proposed structure is in conformity with all applicable City of
Yelm reg ions including t Ise governing zoning and land subdivision, and in addition, all covenants,
easement and strictions f record. If applying as a contractor, I further certify that I am currently
registered n th tate of ashington.
Signature ..OtA— l- Date (-V
Firm
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of
(36 ) 458 -3Y�lm 244
REC #: 00232965 6/03/2016 8:27 AM
OPER: CO TERM: 001
REF #: 21010
PAID BY:
TRAN: 33.0000 BUILDING PERMITS
20160226 29.5(iCR
KRUEGER, PHYLLIS
14915 PRAIRIE VISTA LP SE
MECH 29.5(CR
TENDERED: 29.50 (HECK
APPLIED: 29,50 -
CHANGE: 0.00
CITY OF YELM b 1514 V
RESIDENTIAL BUILDING PERMIT APPLICATIPAI FORMA �1
Project Address C
JAI V) j Par el
Subdivision: Lot #: Plan #: Zoning:
New Construction Re -Model / Re -Roof / Addition i Home Occupation Sign
Plumbing mechanical Mobile / Manufactured Home Placement Other
Project Description /Scope of Work: ?, m /ire p + I a u, e A S wa- e k16(-4-C,,y
Project Value:
Building Area (sq. ft) 1St Floor 2nd Floor 3rd Floor Garage -2 car 3 car
Covered Patio Covered Porch Patio Deck
# Bedrooms_ # Bathrooms_ Heatin : �GAATHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? �J d
/f yes, a completed environmental checklist must accompany permit application.
BUILOW OWNER NAME: ST><F ) EMS
ADDRESS
CITY STATE ZIP TELEPHONE ( t) L C
E#
ADDRESS AIL
CITY STATE ZIP TELEPH
ADDRESS_
CITY TE ZIP
CQNTRA -t R'S LICENSE #
EMAIL
EXP DATE CITY -6 C.E_NSE #.
PLUMBING C TELEPHONE
ADDRESS--- -
CITY STATE ZIP FAX
C CTOR'S LICENSE # EXP DATE CITY LICENSE #
EQ. TELEPHONE
M
ADDRESS I tjl S CJPL EMAIL _ K r
CITY 5 /I Y l I STATE ZIP Cm, i( FAX
CONTRACTOR'S LICENSE # C EXP DATE_,�- CITY LICENSE #
I - t-('I S
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.
va!�A ALV�
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
FAY
105 Yelm Avenue West
Yelm, WA 98597
www.ci.yelm.wa.us
458 -3835
o) 715 -1, T,r,a-------