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20170131 Permit Pkg 02232017
City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Applicant: Name: DAVID & HEIDI HOADLEY Address: 10756 PALISADES ST SE YELM WA 98597 Property Information: Site Address: 10756 PALISADES ST SE Assessor Parcel No.: 67110001500 Subdivision Contractor Information: Name: SUNSET AIR INC Address: 5210 LACEY BLVD. SE LACEY WA 98503 Contractor License No.: Project Information: Project: MECHANICAL Description of Work: ADD HEAT PUMP Permit No.: 20170131 Issue Date: 2/23/2017 (Work must be completed within 180 days) Phone: 360- 878 -2747 Owner: DAVID HOADLEY PALISADES WEST Lot: 15 Expires Phone: 12/31/2017 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 trmfions of record. If applying as a contractor, I further certify that I am currently registere a State hington Signature Date �� 2� • X17 Firm Fees $ 29.50 $ 29.50 OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: Cite ofelm (36 i) 458 -3244 REC #: 00260767 2/23/2017 6:22 AM Opp: CO TERM: 001 REF #: 35578 PAID BY: TRAM: 33.0000 BUILDINGS P[RM113 20170131 HOADLEY, DAVID & HEIDI 10756 PALISADES 2ST5(CR MECH IENDERED: 29.50 (HECK. APPLIED: 29.50 - CHANGE: 0.00 F_(�t�1)1 CITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM Project Address: �ay,1 yak `mil � P rcel #: Subdivision: Lot #: Plan #: Zoning: ❑ New Construction C] Re -Model / Re -Roof / Addition ❑ Home Occupation Sign E Plumbing Mechanical ❑ Mobile / Manufactured Home Placement E Other Project Description/Scope of Work: 1(r_ P ( �,( f� p Al yd Project Value: x 1 b © 0 Building Area (sq. ft) 1 s` Floor 2 "d 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. TELEPHONE LICENSE # ADDRESS EMA1 L CITY STATE ZIP TELEPHONE ADDRESS CITY STAY CONTRACTOR'S LICENSE # ZIP TELEPHONE EMAIL FAX EXP DATE CITY LICENSE # .m TELEPHONE ADDRESS EMAIL CITY STAT ZIP FAX CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # ADDRESS CITY _SIIATE_ WA, _ZIP CONTRACTORS LICENSE #<41 4-d ,}-2-4.ot,0ItXP DATE CITY LICENSE #_ Copy of mitigation agreement with Yelm Com unity �chools, if applicable. TELEPH EMAIL fy that the above information is correct and that the construction on, and the occupancy and the use of the bed property will be in accordance with the laws, rules and regulations of the State of Washington and the Ci�q of Y Im. Appli ant's gidnature 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 neru3A I lkvp within 180 days of issuance, or if work is suspended or abandoned for a pe tas�/ ' FrB 1 2U 11 i BY .. --- - - - - -- 105 Yelm Avenue West (360) 458 -3835 Yelm, WA 98597 (360) 458 -3144 FAX www.c4ye1nzava.us