20170136 Permit Pkg 03232017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: MICHAEL & KELLY SHAFFER
Address: 14958 91 ST AVE SE
YELM WA 98597
Property Information:
Site Address: 14958 91ST AVE SE
Assessor Parcel No.: 33860002400
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 AIR CONDITIONER
Sq. Ft. per floor:
First
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Subdivision:
Permit No.: 20170136
Issue Date: 3123/2017
(Work must be completed within 180 days)
Phone: 323 - 346 -7987
Owner: MICHAEL SHAFFER
BELLA HOUSA Lot: 24
Expires:
Phone:
0 /00 /0000
Heat Type (Electric, Gas, Other):
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 the State of Washington.
Siqnature C/� L Date d31Z 3/�7
Firm
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
m of Yelm
3g ,of 458 -3244
REC #: 00263718 3/23/2017 6:53 AM
OPEP* CO TERM: 001
REF #: 35600
PAID BY:
TRAN: 33.0000 BUILDING 9.5(CRII3
20170136
SHAFFER, MICHAEL & WELLY
14958 91ST AVE SE
MECH 29.5(CR
TENDERED:
29.50 (HECK
APPLIED:
29.50 -
CHANGE: _
0.00
CITY OF YELM f ✓ °~�'" v
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: L4q V y q ` `� AVgl0 Parcel #: 2') b U P 00())-q0_0
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Subdivision: Lot #: Plan #: Zoning:
❑ New Construction ❑ Re Model 1 Re -Roof / Addition ❑ Home Occupation Sign
❑ Plumbing Mechanical U Mobile 1 M nUfactured Home Placement D Other
Project Description /Scope of Work: ru
Project Value:
Building Area (sq. ft) 1s1 Floor — 2 r Floor 3`d 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.
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ADDRESS EMAIL
CITY STAT ZIP TELEPHONE
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CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
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CONTRAC R'S LICENSE #�1x r �uXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Commuu`itytkhools, if applicable.
0ccClt Itf
I hereb certify that the above information is correct and that the construction on, and the occupancy and the use of the
aho de cribed property will be in accordance with the laws, rules and regulations of the State of Washington and the
Ci #of Y Im.
Appli ant's i nature Date
Owner 1 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
MAR ""
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105 Yelm Avenue West (3 am y58 -3835
Yelm, WA 98597 (36 ) 45$=J__rTrT.',ff " " " ".•
www.cl.yelm.wa. us