20170175 Permit Pkg 04262017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20170175
Issue Date: 4/26/2017
(Work must be completed within 180 days)
Applicant:
Name: MICHAEL MASCHERINI Phone: 360- 960 -8971
Address: 16475 GREENBRIER ST SE
YELM WA 98597
Property Information:
Site Address: 16475 GREENBRIAR ST SE Owner: MICHAEL MASCHERINI
Assessor Parcel No.: 56510003900 Subdivision: JOHNS MEADOWS Lot: 39
Contractor Information:
Name: BOB'S HEATING & AIR Phone:
Address:
14148 NE 190TH ST
WOODINVILLE WA 98072
Contractor License No.: 10102 Expires: 12/31/2017
Project Information:
Project: MECHANICAL
Description of Work: ADD AC TO EXISTING HVAC SYSTEM
Sq. Ft. per floor: F. Heat Type (Electric, Gas, Other):
first
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
BOB'S HEATING & AIR
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 tho governing zoning and land subdivision, and in addition, all covenants,
easements and restr Fin, ord If applying as a contractor, I further certify that I am currently
registered in the o
Signature Date Z%
Firm
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
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(36t ) C, 08 PM
00266919 4/26/2017
RECD: TERM: 001
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REFS
PAID BY�
IRAN:
33.0000 BUILDI29 5(CRII'
20,70175 A5CHERINI, MICHAEL
16475 GREENBRIAZ9 50 SE
MECH
29 50 ( HECK
IE.NGERED: 29,50 -
P,PPLIEU : _
.00
CHANGE:
04/17/2017 MON 22:02 FAX
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CITY OF YELM
RESIDENTIAL 13UILDING PERMIT APPLICATION FORM
Project Address: 16475 Greenbrier St SE Parcel #: 56510003900
Subdivision: I Lot #: Plan #:_ Zoning:
❑ New Construction 0 Re -Model I Re -Roof / Addition ❑ Home Occupation Sign
❑ Plumbing X Mechanical n Mobile / Manufactured Home Placement o Other
Project Descrlptlon /scope of Work: add ac to existing hvac system
Project value: 8400.00
Building Area (sq. ft) 1" Floor 2nd Floor Garage Deck
Basement Carpor4.._ Patlo
# 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,
IILtS} chael Mascherini
ADDRESS 16 5 G[agn tier EMAIL
CITY Y6111]_ STATE a ZIP —TELEPHONE 360 -4aO -8571
OW, y �TIVI, ,IN9 . LICENSE #
ADDRESS EMAIL
CITY 6TATE ZIP TELEPHONE
1,1 TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE N.
:
`ItA+141;I;G1,PC=R TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #.
Cow. ; T s at n TELEPHONE - -
N 9
0t
ADDRESS 1414M th 1151 EMAIL lgosnell o s ea m .com
CITY STATEAZIP� - FAX
CONTRACTOR'S LICENSE # 85 EXP DATE T lUTY LICENSE # 13- 000,39,3,0
Copy of mitigation agreement with Yeim Community Schools, if applicable.
I hereby cartify, that the above Information is correct and that the aonstruotlon on, and the occupancy and the use of the
above described property will be In sccordance with the laws, rules and regulations of the State of Washington and the
CRY of Yelm.
4/18/17
Applicant's Signature Date
Owner / Contractor / Owner's Agent / Contractor's Agent (Please circle one.)
All permits are nonrtransferabla and will expire If worts 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
105 Yahn Avenue West
Yetm, WA 9869?
wrura.dt yelm.W4. ue
(860) 458 -8885
(360) 08 -1144 FAX
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