20160291 Permit Pkg 07152016City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: COLTEN & JENNIF HUDNELL
Address: 9870 JENSEN DR SE
YELM WA 98597
Property Information:
Site Address: QR7n _IFNSFN np SF
Assessor Parcel No.: 78640107200
Contractor Information:
Name: SUNSET AIR INC
Address: TERRY MEDLOCK
5210 LACEY BLVD.
LACEY WA 98503
Permit No.: 20160291
Issue Date: 7115/2016
(Work must be completed within 180 days)
Phone: 360- 359 -5978
Owner: COLTEN HUDNELL
Subdivision: TAHOMA TERRA Lot: 72
Contractor License No.: SUNSEA1915131 Expires
Phone:
1/21/2017
Project Information:
Project: MECHANICAL
Description of Work:
HEAT PUMP INSTALLATION
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 th�e.St�ate .of Washington.
Si�iG" � Date
Firm w554 1-4
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
CITY OF YELM f " 2--, + 0
/�AA
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: vl % Iv Amin �in 0 ( 5E- Parcel #: � U9
Subdivision: Lot #: Plan M Zoning:
I
❑ New Construction ❑ Re -Model / Re -Roof 1 Addition ❑ Home Occupation Sign
❑ Plumbing Mechanical ❑ Mobile ! Manufactured Home Placement [I Other
Project Description/Scope of Work: Ne gV00
Project Value: q"6 vl O
Building Area (sq. ft) 1St Floor 2"" 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.
FEE 111AIMMer-RIAND, 19 isom-OWP; I FWNA�_,/
EMAIL
LICENSE #
ADDRESS EMAIL
CITY TATS ZIP TELEPHONE
_ _ _ TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR LICENSE # EXP DATE CITY LICENSE #
01 �5 TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S L ENSE # EXP DATE CITY LICENSE #
r;: - ►�.t,'I' J111 t�. )U' TELEPHONE ', tV() `isle- qt)
A ~ all 6 U 5 _. EMAIL ,Sla 1� . �i r . coyi""
CITY Iz _S ATE WIA, ZIP as�FAX — L
CONTRAC R'S LICENSE #!�4,(.VL>!_" 2J-ULV)XP DATE CITY LICENSE #
31(�i11
Copy of mitigation agreement with Yelm Community Schools, if applicable.
X,b,,,, certify that the above Information is correct and that the construction on, and the occupancy and the use of the
e d cribed property will be in accordance with the laws, rules and regulations of the State of Washington and the
of Y Im.,
Applicant's Signtiture Date
Owner 1 Contractor 1 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 rJUOL" y UTIC
1 2016
105 Yelm Avenue West (360) 4
rrrrr mass
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.yelm.wa.us
36t' 4f Yell
458 -3244
: 00237
Op"'. CO 589
REF&: 35378 TERM
PA 1[, 8 y,
IRAN: 33.0000
20160291
HUDNELL
9870 ;
MECH JEN
TENDERS
7115/2016
001 12 :03 pM
BUILDING pf
29 5(CRMIrs
)EN TEN F JF NN F
29.5(CR
AppLIEDD 299.50
50- (HECK
CHANGE:
0.00