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20160280 Permit Pkg 07082016o,c TH-e City of Yelm ?A, Community Development Department a Building Division Phone: (360) 458 -8407 L Fax: (360) 458 -3144 Applicant: Name: LINDA JONES Address: 9301 PRAIRIEWIND ST SE YELM WA 98597 Property Information: Site Address: 9301 PRAIRIEWIND ST SE Assessor Parcel No.: 6441000200 Subdivision: Contractor Information: Name: SUNSET AIR INC Address: TERRY MEDLOCK 5210 LACEY BLVD. LACEY WA 98503 Contractor License No.: SUNSEAI91561 Expires Project Information: Project: MECHANICAL Description of Work: INSTALL AC Sq. Ft. per floor: First Second Third Garage Basement Fees: Item MECHANICAL Permit No.: 20160280 Issue Date: 7/08/2016 (Work must be completed within 180 days) Phone: 253 - 880 -4850 Owner: LINDA JONES Phone: 1/21/2017 Heat Type (Electric, Gas, Other): Lot: 20 Contractor Fees LINDA JONES $ 29.50 TOTAL FEES: $ 29.50 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 restricti s of record. If appl i s a contractor, I further certify that I am currently registered in the 9fat f Washington r Signature Date Firm s/ OFFICIAL USE ONLY # Sets of Prints. Final Inspection: Date. By: Cite of Yelm (36C1 ) 458 -3244 'EC"': 00236540 REF*:' 35371 TERM: 000 8/2016 8 :13 AM PAID 8Y; IRAN: 33.0000 2016028000 PfRMITS JONES, LINDA 29.5CCR 9301 PRAIRIEWIND MECH ST SE TENDERED 29.5CCR APPLIED; 29.50 CHECK 29.50- C,'HANGE : --- 0.00 CITY OF YELM�� RESIDENTIAL BUILDING PERMIT APPLICATION FORM Project Address: "I ©� �� ����� Yr Parcel #: ULN1 QQQc 00 Subdivision: Lot #: Plan #: Zoning: ❑ New Construction E i Re -Model / Re -Roof / Addition ❑ Home Occupation Sign ❑ Plumbing Mechanical /� [I Mobile / M/fanufactured Home Placement ❑ Other Project Description /Scope of Work: it tM) &to �� r aao / Project Value: Z; Building Area (sq. ft) 1St Floor 2nd Floor 3rd Floor Garage -2 car 3 car Covered Patio Covered Porch Patio Deck # 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 Ot%Vf�ER n ADDRE . S rI Ni EMAIL CITY STATE k JIA ZIP TELEPHONE ARCHITECT /ENGINES. LICENSE # ADDRESS EMAIL CITY STAT ZIP TELEPHONE ADDRESS�� CITY CONTRACTOR'S LIC TELEPHON EMAIL STATE ZIP FAX XE # EXP DATE CITY LICENSE # PLUMBING,C©NTRAC' R TELEPHONE ADDRESS EMAIL CITY STA — Z 1P FAX CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # MEC1- jAN [CAL CONTRAGTO L>A-,'t" t9l TELEPHONE .)VL)— TJV-`J4 -pLe ADDRESS SEE- EMAIL P ., %( A),St+-rL,,r- iOm-, CITY Q S ATE FAX :O - J - ZIP Q{ 'er CONTRAC R'S LICENSE #5 nX Il Z ZLUOIVP DATE CITY LICENSE # 1 510// Copy of mitigation agreement with Yelm Community chools, 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 oflyelm. 6�(-z J /l V Applicant's Si nature 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