20160276 Permit Pkg 07062016Applicant:
City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458-3144
Permit No.: 201 60276
Issue Date: 7/06/2016
(Work must be completed within 180 days)
Name: PHILIP PERRY Phone: 360- 458 -5429
Address: 16151 PALOUSE AVE SW
YELM WA 98597
Property Information:
Site Address: 16151 PALOUSE AVE SE Owner: PHILIP PERRY
Assessor Parcel No.: 32640000500 Subdivision: Lot:
Contractor Information:
Name: BRENNAN HEATING Phone:
Address:
4601 S 134TH PL
SEATTLE WA 98168
Contractor License No.: 10111 Expires: 12/31/2016
Project Information:
Project: MECHANICAL
Description of Work: CHANGE OUT GAS FURNACE AND INSTALL 3 TON HEAT PUMP. DUCT LEAKAGE TEST
REQUIRED
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
BRENNAN HEATING
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 of Washington. (, \
Signature t e a n. AT Uw Date 7 -( /
,
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
(TO of Yolm
(36 458 -3244
RECD`: 00236362 ERM: 00162016 1:08 PM
OPER: CO
REFS': 44535
PAID BY:
TRAM: 33.0000 BUILDING 5tCMRITS
20160276
PERRY, PHILIP
16151 PALOUSE AVE E 5tCR
MECH
TENDERED: 29.50 CHECK
APPLIED: 29.50 -
CHANGE : 0.00
01(e C66-7(p
CITY OF YELM
/RESIDENTI L BUILDING PERMIT APPLICATION FO/ RM
Project Address: i IL01 1 { 6k) W.& � Parcel*
Subdivision: Lot #: Plan #: Zoning:
New Construction ❑ Re -Model / Re -Roof / Addition Home Occupation Sign
Plumbing F4Mechanical ❑ Mobile / Manufactured Home Placement E Other 1
Project Descriptio Scope of Work: A- Q Ct S �u t AA t -t -4 111 � � '3 —`6n
Project Value: u�
Luc,+f l r�6ui'- -ed .41
Building Area (sq. ft) 15' Floor 2nd Floor Garage Deck
Basement Carport Patio
# 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.
BUILDING OWNER NAME: f
ADDRESSJSLi. Gx- EMAIL
CITY STATE ZIP TELEPHONE ty t7 .
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 44AA\A^ V"_ TELEPHONE `' Qko. + '6. M
ADDRESS �to�t S 134 l.. EMAIL CtittrlSlf: �l , t4n�.s�'a M4
CITY,. A STATE W e. ZIP FAX C C)s
CONTRACTOR'S LIC SE # EXP DAT ITY LICENSE #
aLFt'1 ri i
Copy of mitigation agreement with Yelm Commu ity Sdhools, if applicable.
I hereby cel4ify at the above information is correct and that the construction on, and the occupancy and the use of the
above describe property will be in accordance with the laws, rules and regulations of the State of Washington and the
City ofYelm.
Ji
App is 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)
Yelin, WA 98597 (360)
www.ei.yelm.wa.us
iti�
x ''
Karen Bennett
From: Jaimie How Daimie @brennanheating.com]
Sent: Thursday, June 30, 2016 12:06 PM
To: Karen Bennett
Subject: Mechanical Application
Attachments: perryyelmapp.pdf
Importance: High
Please let me know the fee due once processed and ready for pick up.
Thank you,
Jaimie How
Permit Coordinator
Brennan Heating and Air
206.248.7900 office
877.273.6626 (toll free)
206.248.7905 fax