20170151 Permit Pkg 03282017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458-3144
Applicant:
Name: JOANNE CHAMBERS
Address: 15214 CARTER LP SE
YELM WA 98597
Property Information:
Site Address: 1 -71A [_APTFR I P SF
Assessor Parcel No.: 52920004100 Subdivision:
Contractor Information:
Name: FAST WATER HEATER
Address:
11715 NORTH CREEK PARKWAY S.
BOTHELL WA 98011
Contractor License No.: FASTWWH948BC
Permit No.: 20170151
Issue Date: 3/28/2017
(Work must be completed within 180 days)
Phone: 253 - 988 -1320
Owner: JOANNE CHAMBERS
Lot:
Phone: 425 - 814 -3124
Expires: 1/04/2021
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
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 also certify that the proposed structure is in conformity with all applicable City of
Yelm regulation including those governing zoning and land subdivision, and in addition, all covenants,
easements and estri ons o cord. If applying as a contractor, I further certify that I am currently
registered in the Stat o W s gton.
Signature I Date J'
Firm APikF H 10TW 101 DA
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of Mm
(36 !) 458 -3244
RECD': 00263930 3/28/2017 4:20 PM
OPER: CO TERM: 001
REEF: 22370
PAID BY:
TRAM: 33.0000 BUILDING PERMII3
20170151 29.5CCR
CHAMBERS, JOANNE
15214 CARTER LP SE
MECH 29.5(CR
TENDERED: 29.50 CHECK
APPLIED: 29.50-
CHANGE: 0.00
CITY OF YELM U12n It 5
RESIDENTIAL BUILDING PERMIT APPLICATION FOR �l ({
Project Address: ,/ I jj T/
T� LIW jParcel #: ��- 1 0� 19 0 y Lit
Subdivision: Lot #: Plan #: Zoning:
E New Construction 1 -1 Re -Model / Re -Roof / Addition Home Occupation Sign
C Plumbing mechanical lJ Mobile/ Manufactured Home Placement 1 Other ((,,,, .. �
Project Descripti /Scope of Work: �Pl�i�P \/'e% 121 a U� G A S U0Q-K k l�4fT
Project Value: 1V 1 99'(.P
Building Area (sq. ft) 1St Floor 2nd Floor 3rd Floor Garage -2 car 3 car_
Covered Patio Covered Porch Patio Deck
# Bedrooms_ # Bathrooms_ Heatin : GAS/ THER 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.
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ADDRESS AIL
CITY STATE ZIP TELEPH
ADDRESS EMAIL
CITY TE ZIP
C R'S LICENSE # EXP DATE NSE #
TELEPHONE
ADDRESS
CITY STATE ZIP FAX -�
C CTOR'S LICENSE # EXP DATE CITY LICENSE #
ADDRESS l k��T $� C EMAIL HONE —b v
CITY � l I STATE ZIP ��
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CONTRACTOR'S LICENSE # FA<,Tkli�40Li S13 C EXP DATE_�/ CITY LICENSE # - (O
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Copy of mitigation agreement with Yelm Community �chools, 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.
�Xw L:�V( 3-- ib -1�7-
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 s ermit is4
within 180 days of issuance, or if work is suspended or abandoned for
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Olt -
105 Yelm Avenue West (360) 458 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.yelm.wa.us