20170156 Permit Pkg 03292017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458-3144
Applicant:
Name: SOMBOONITRIC HERNANDEZ
Address: 14829 TERRA VIEW ST SE
YELM WA 98597
Property Information:
Site Address: 1AA9Q TERRA VIEW AT CF
Assessor Parcel No.: 78640018500
Contractor Information:
Name: ALL SEASONS INC.
Address:
5001 N 28TH ST
TACOMA WA 98407
Contractor License No.: ALLSEI" 03055
Permit No.: 20170156
Issue Date: 3/29/2017
(Work must be completed within 180 days)
Phone: 910- 603 -3174
Owner: SOMBOON HERNANDEZ
Subdivision: TAHOMA TERRA Lot: 185
Phone: 253 - 879 -9143
Expires: 12/17/2018
Project Information:
Project: MECHANICAL
Description of Work: CHANGE UNCASED COIL AND INSTALL AC UNIT
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
ALL SEASONS 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
register a-tlle`State of Washingto .
Signature Date
Firm
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of Y ell
(36 0 458-3244
REC #: 00263940
OPER: CO 3/29/2017 9.
REF #: TERM: ppl 36 AM
PAID BY:
ACCT #: XXXXXXXXXXXXXXXXXXX
AUTH #: 08095Z
IRAN #: 000000004768
TYPE: PURCHASE
IRAN: 30.0000
ALL SEASONS INC INC
LICENSE
BUSINESS LICENSES 4
"RAN: 33,0000 35.00CR
20170156 801LOING PERMITS
HERNANDEZ, SUM OpN,�RIC.
MECH
14829 TERRA VIEW ST SE
29.5CCR
1ENDEREU:
APPLIED: 64.50 CREDIT CARD
64.50 -
1,'HANGE:
0.00
�/I 'V 15�
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
14 V'1 lerrc.V ST St
Project Address: ' -Im J w,a 98S97 Parcel #: 7X it'1 CC 1 '�5 50C
Subdivision: Lot #: Plan #: Zoning:
New Construction - Re -Model / Re -Roof / Addition Home Occupation Sign
Plumbing A Mechanical Mobile / Manufactured Home Placement Other
Project Description /Scope of Work:_ C.1NC,VNL7tf vntG ZCi Cc
Project Value-4 ? Lam 3 E: , 5 3
Building Area (sq. ft) 1" Floor `1 j6 2nd Floor I 1 ? 3,d Floor_
Covered Patio Covered Porch 11-14 Patio
Garage -2 car 410 3 car
Deck ZS L
# Bedrooms 3 # Bathrooms 2 Heating: GAS /OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? A. ' /A
If yes, a completed environmental checklist must accompany permit application.
BUILDING OWNER NAME:
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTORA11 5FA561GS, -FA C. TELEPHONE G53 g-7 I - 91yy
ADDRESS 4`69 -1 5 f-o� sf, sf-& 6 EMAI ec- ,4C1-&4VSC �ft�tat�:c -.tn
CITY 'Tc Lc, k -,-\ STATE �,. A ZIP 9S-105 FAX (Zs3) 6"�9 - 91H 3
CONTRACTOR'S LICENSE EXP DATE�CITY LICENSE # .4PI'I-e,4
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.
Applicant's lgnature_ Date
Owner / Contractor / Owner's Agent / ontractor's Agent ( se 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 p ; Lad of-lAft
I' 841 MAR 2 2017
105 Yelm Avenue West 8001 458 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.yelm.wa.us