20170154 Permit Pkg 03282017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: SUSAN CROY
Address: P.O. BOX 1081
YELM WA 98597
Property Information:
Site Address: 1717 THI IRCTCIN C_T NW
Assessor Parcel No.:
Contractor Information:
Name: FAST WATER HEATER
Address:
11715 NORTH CREEK PARKWAY S.
BOTHELL WA 98011
Contractor License No.: FASTWWH948BC
Subdivision:
Expires:
Permit No.: 20170154
Issue Date: 3/28/2017
(Work must be completed within 180 days)
Phone: 360- 259 -8382
Owner: SUSAN CROY
Lot:
Phone: 425 - 814 -3124
1/04/2021
Project Information:
Project: MECHANICAL
Description of Work: REMOVE AND REPLACE ELECTRIC 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' Affidavit:
I certify tha I have read and examined the information contained within the application and know the same
to be true 4nd correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regu ti those governing zoning and land subdivision, and in addition, all covenants,
easement and strictions of record. If applying s a contractor, I further certify that I am currently
registered n th to of ashington. r7
Signature Date
Wen 1
Firm Vii,. (, --)r - k_� Wen �0 .�
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
( 611 a458e3I
(36
REC #: 00263933 3/28/2017 4.:22 PM
OPER: CO TERM: 001
REF #: 22344
PAID BY:
TRAM: 33.0000 BUILDING P[RMII'3
20170154
CROY, SUSAN
1217 THURSTON C29N5(CR
MECH
I E:NOERED : 29.50 ( HECK
APPLIED: 29'50
CHANGE: � —J 0,00
CITY OF YELM pt um
Q�
RESIDENTIAL BUILDING PERMIT �APPLICATION IFORM U P6�6
Project Address: �� ��S�Z'v GT ' parcel #: lP DD
Subdivision: Lot #: Plan #: Zoning: 09(-70f`5/-/
I-- New Construction n Re -Model / Re -Roof / Addition ❑ Home Occupation Sign
Plumbing E Mechanical ❑ Mobile / Manufactured Home Placement -1 Other
Project Description /Scope of Work: P,W1 Dy� /{�� 101 Q .- C �t°_ � � C (/)Qw kia-
Project Value: P5-5
Building Area (sq. ft) 1St Floor 2nd Floor 3rd Floor Garage -2 car 3 car.
Covered Patio Covered Porch Patio Deck
# Bedrooms_ # Bathrooms_ Heating: GAS /OTHER =ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? �J d
/f yes, a completed environmental checklist must accompany permit application.
ii1► . " 1
111 ' 1.� , '
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ADDRESS AIL
CITY STATE ZIP TELEPH
ADDRESS EMAIL
CITY TE ZIP
C R'S LICENSE # EXP DATE NSE #
Q. W Q TELEPHONE
ADDRESS I Cr 5 C -10 (, EMAIL
CITY STATE_ IP qn I I FAX
CONTRACTOR'S LICENSE #fASTWW),H9N8RC EXP DATE CITY LICENSE #
1-
_
TELEPHONE
ADDRESS --
CITY S--T-
AT
CTOR'S LICENSE #
EXP
ENSE #
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.
Ky"
Applicant' ture Date
Owner Contracto / 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 per' MIASTIC
MAR 2 7 2017
105 Yelm Avenue West
Yelm, WA 98597 (360) 458 -3144 FAX
wwwxLyelm.tva.us