20170181 Permit Pkg 05022017Applicant:
City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20170181
Issue Date: 510212017
(Work must be completed within 180 days)
Name: SHARIECE SUMMERS Phone:
Address: 9974 JENSEN DR SE
YELM WA 98597
Property Information:
Site Address: 9974 JENSEN DR SE Owner: SHARIECE SUMMERS
Assessor Parcel No.: 78640105700 Subdivision: TAHOMA TERRA Lot: 57
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: First Heat Type (Electric, Gas, Other):
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 those g erning zoning and land subdivision, and in addition, all covenants,
easements and res tions of re . If applying as a contractor, I further certify that I am currently
registered in th t of Was gton.
Signature Date 03 -o2Dr.-
Firm
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Mm
(36 ) 458 -3244
REC #: 00267623 5/03/2017 10:41 AM
OPER: AS TERM: 007
REF #: 600782
PAID BY:
IRAN: 33.0000 BUILDING PERMITS
20170181 29.50CR
SUMMERS, SHARIECE
9974 JENSEN DR SE
MECH 29.50CR
TENDERED: 29.50 CHECK
APPLIED: 29.50-
CHANGE: 0,00
04/28/2017 FRI 0:26 FAX 0001/002
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address; 9974 Jerisen Dr fie parcel #: 78640105700
Subdtvlslon: Lot #: Plan #: Zoning:
❑ New Construction ❑ Re -Model I fie -Roof / Addition ❑ Home Occupation Sign
❑ Plumbing fd(Mochanlcal o Mobile / Manufactured Home Placement ❑ Other
Project DeacriptlonlScope of work: Add ac to existing hyac system
Project value: 6600.00
Building Area (sq. ft) 1" Floor 2 "d Floor Garage Deck
Basement Carport Patio
—
# Bedrooms— # Bathrooms_ Heating: GAS /OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel?
Ii yes, a completed environmental checklist must accompany permit application.
)W' ar ce mmers
ADDRESS 7 Jensen Or Se EMAIL
CITY Yelm STATE Wa -SIP -- TELEPHON - -
CITY STATE ZIP TPLE
TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP F
CONTRACTOR'S LICENSE # EXP DATE—CITY LICENSE #
J0 TELEPHONE
ADDRESS EMAIL
CITY STATEZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
CHf s ea in -q TELEPHONE
ADDRESS 141 NN 9 h EMAIL Ihoneycu _ o s ea ng.Com
CITY Wnodinville STATE WA ZIP 9� 8072 FAX
CONTRACTOR'S LICENSE B5 3 EXP DATE9f711 'CITY LICENSE # 13- 000303.0
Copy of mitigation agreement with Yelm Community Schools, If applicable.
I hereby eartlfy that the above Information le corset and thel the annatruetlon on, end the oeoupancy end the use of the
above described property will be In accordance with the laws, rules and regulations of the State of Washington and the
Cltyof Yelm,
4/26/17
5�p—piiiiiknrs Signature bate
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 not begun
within 180 days of Issuance, or it work Is suspended or abandoned for a period of 180 days
106 Yam Avenue West
Yelm, WA 8807
rumm.dL.yetm.Wd.ue
(860) 458 -8885
(860,08-8144 FAX
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