20170153 Permit Pkg 03282017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: EMILY SILVA
Address: 9975 GREENLEAF LP SE
YELM WA 98597
Property Information:
Site Address: 007 rRFFIUI IFAF I P CF
Permit No.: 20170153
Issue Date: 3/28/2017
(Work must be completed within 180 days)
Phone: 360- 400 -1980
Owner: EMILY SILVA
Assessor Parcel No.: 84070003300 Subdivision: WILLOW GLEN, PHASE II Lot: 33
Contractor Information:
Name: FAST WATER HEATER
Address:
11715 NORTH CREEK PARKWAY S.
BOTHELL WA 98011
Contractor License No.: FASTWWH948BC
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 regulations including those governing zoning and land subdivision, and in addition, all covenants,
easements M rd. If applying as a contractor, I further certify that I am currently
registered i Signature �► � [ Date
/rl�l
Firm ��(1 I1 �1 0 0�
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Yelm
(361) 458 -3244
REC#: 00263932
OPER CO 312812017
REF4:: 22369 TERM: 001 4:21 PM
PA 1[1 8y:
IRAN: 33.0000
20170153
BUILDING E
P RMITS
SILVA,
9975 GREENLEAF
EMILY 29.5(CR
MECH
LP SE
TENDERED.
29•5(CR
APPLIED:
29.50 (NECK
29.50 -
C"'HANGE:
O.00
IVl � �
U8���`l3
CITY OF YELM D
RESIDENTIAL BUILDINGrr P)E6�R -M�ITCAPPLICATION FORM
Project Address: C ��r���'I' 'N`'f Parcel #:
Subdivision: Lot #: Plan #: Zoning:
E New Construction 1-1 Re -Model / Re -Roof / Addition Home Occupation Sign
E Plumbing Mechanical i Mobile / Manufactured Home Placement I Other ,,,
Project Descriptio Scope of Work: �P1�P V - Ire p a u— C-2 4S W, a4 �' /
[,,-i6(-
Project Value:' I
Building Area (sq. ft) 15` Floor 2nd Floor 3rd Floor Garage -2 car 3 car
Covered Patio Covered Porch Patio Deck
# Bedrooms_ # Bathrooms_ Heatin OGAS/ TH ER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? �J D
If yes, a completed environmental checklist must accompany permit application.
rA
UERSE
ADDRESS AIL
CITY STATE ZIP TELEPH
ADDRESS
CITY
MAIL
STATE ZIP -CFA,
S LICENSE # EXP DATE G1i`Y-L- ICENSE #
TELEPHONE
ADDRESS
CITY STATE ZIP FAX
C CTOR'S LICENSE # EXP DATE CITY LICENSE #
LJ TELEPHONE
ADDRESS 1 S# C EMAIL LKE ULF- J?-V r
CITY STATE ZIP 9a I I FAX
CONTRACTOR'S LICENSE #fA9kJW-fC1L/,f a C EXP DATE__�(- CITY LICENSE
I -H- `is
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.
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 nnott be un
within 180 days of issuance, or if work is suspended or abandoned fo 't�dS�7'
MAR 27 2017
105 Yelm Avenue West (360) 458 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.yelm.wa.us