20160357 Permit Pkg 11042016City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458 -3144
Applicant:
Name: ROBERT HARTER
Address: 14936 PRAIRIE VISTA LP
YELM WA 98597
Property Information:
Site Address: 1AA36 PRAIRIE VISTA LP SE
Assessor Parcel No.:
Contractor Information:
Name: A PLUS SERVICES
Address:
7225 PACIFIC AVE SE
OLYMPIA WA 98503
Contractor License No.: ALECS*994NO
Subdivision:
Permit No.: 20160357
Issue Date: 11104/2016
(Work must be completed within 180 days)
Phone: 360- 960 -1082
Owner: ROBERT HARTER
Lot:
Phone:
Expires: 8/29/2017
Project Information:
Project: MECHANICAL
Description of Work: INSTALLING FURENACE AND HEAT PUMP
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
A PLUS SERVICES
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 restriction of record. If applying as a contractor, I further certify that I am currently
registered in th tate ashing
Signature Date l
Firm
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City ofe1m44
(36C
REC #: 00248678
OPER: CO TERM
REFS`: 36207
PAID V :
11/04/2016 x:02 AM
001
NG PERMITS
TRAM: 33.0000
BUILDI
29.5(CR
20160357 ROBERT
HARTER, r" 'E
PRAIRIE V29 A
14936
CR
bIECH
1E.NOERED:
29.50 CHECK.
29'50 -
APPLIED:
CHANGE:
3s�
CITY OF YELM h is o
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: l q f 36 Pr'c,;r; e sc Parcel #: g I T4 0005(000
Subdivision:
Lot #: Plan #: Zoning:
New Construction - Re -Model / Re -Roof / Addition i- Home Occupation Sign
Plumbing ✓Mechanical I Mobile / Manufactured Home Placement I Other
rr
Project Description /Scope of Work: ohs ��� �,� �nr hkce- And hP&J- p-tW**
Project Valuer
Building Area (sq. ft) 1St Floor 2nd Floor 3`d 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? A/o
If yes, a completed environmental checklist must accompany permit application.
BUILDING OWNER NAME: 5eAe 14n, <<
ADDRESS /q934 2r 'rie- l L EMAIL
CITY Ye.Ir►, STATE W_A_ IP 9 TELEPHONE 60- 985 -80.53
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 A+ Sew;ces TELEPHONE 360-q 1-7-900
ADDRESS 7-225 h#.c),Gc_ Ave SL EMAIL r12&S e.11 r,,e1H- cnhN+Cr.
CITY Ol w, STATE �_ZIP 503 FAX 3100— y9/ -/990
CONTRAC OR'S LICENSE #AEt_EC_5*FJY o EXP DATE r! ITY LICENSE # /60 /Z-
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.
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