20170106 Permit Pkg 01112017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: ZACHARY MENDEL
Address: 9838 GREENLEAF LP SE
YELM WA 98597
Property Information:
Site Address: 4RAR r.PFFNI FOF I P SF
Permit No.: 201 70106
Issue Date: 1111/2017
(Work must be completed within 180 days)
Phone: 360- 870 -2015
Owner: ZACHARY MENDEL
Assessor Parcel No.: 84070005700 Subdivision: WILLOW GLEN PHASE II Lot: 57
Contractor Information:
Name: FAST WATER HEATER
Address:
12601 132 ND AVE. SE
KIRKLAND WA 98034
Contractor License No.: 10236 Expires
Phone:
12/31/2017
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
I
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 and correct. I al ify that the proposed structure is in conformity with all applicable City of
Yelm regulations incLwding those overning zoning and land subdivision, and in addition, all covenants,
easements $nd restrictions of re rd. If applying as a contractor, I further certify that I am currently
registered injthe Stat of Wash gton.
Signature ' A ` Date �• (I • ��
Firm bA_ Leh—ILA.
A
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of Yolm
(36 1 458 -3244
RECD': 00255587 1/11/2017 3:56 PM
OPER: CO TERM: 001
REEF : 21905
PAID BY:
TRAM: 33.0000 BUILDING PERMITS
20170106 29 0 CR
MENDEL, ZACHARY
9838 GREENLEAF LP SE
MECH 29 S CR
TENDERED: 29.50 (HECK
APPLIED: 29.50-
CHANGE: 0.00
IY I 1?1C�I
CITY OF YELM
p7 QRESIDENTIAL BUILDING PnEDRMIT APPLICAQTIION, FORM
�
Project Address: to 5 ¢ l��) ���1' SP Parcel #: ✓ �� 1 �y��
Subdivision: Lot #: Plan #: Zoning:
gq0I,�,
P70100
E New Construction Re -Model / Re -Roof / Addition Home Occupation Sign
E Plumbing mechanical Mobile / Manufactured Home Placement 1 Other
f,,,� I,
Project Description /Scope of Work: �P ycIre p � �- �!' S Ul 0,4 '`-tea -�
Project Value: � I `J
Building Area (sq. ft) Vt Floor 2nd Floor 3rd Floor Garage -2 car 3 car
Covered Patio Covered Porch Patio Deck
# Bedrooms_ # Bathrooms_ Heatin OGAS/ THEIR or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? K 0
If yes, a completed environmental checklist must accompany permit application.
ADD' weril "10do
EMAIL
ANIP 3(d)
E#
ADDRESS AIL
CITY STATE ZIP TELEPH
ADDRESS EMAIL
CITY -----STATE ZIP
C R'S LICENSE # EXP DATE - IDENSE #
TELEPHONE
ADDRESS - --EMA -U _
CITY STATE ZIP FAX
C CTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR t,JPM -_ K TELEPHONE ;b `
ADDRESS I ftl �_ $ Cjbi, EMAIL K- KE%rLF_ Sf LA ea+i
CITY l I STATE ZIP 9M ( FAX
CONTRACTOR'S LICENSE #f/ISTk1W4f6?L /S3 C EXP DATE__�el CITY LICENSE #
I - LI - $
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.
V�2�M ou:��Z� Ld -62S_1b
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
AP
1-16—)7
105 Yelm Avenue West (360) 458 -3835
Yelm, WA 98597 _ (360) 458 -3144 FAX
www.ci.yelm.wa.us