20170193 Permit Pkg 05182017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: DARYL & SHANNON GUTIERREZ
Address: 14727 91 ST AVE SE
YELM WA 98597
Property Information:
Site Address: 14727 91 ST AVE SE
Assessor Parcel No.: 33860004800
Contractor Information:
Name: SUNSET AIR INC
Address:
5210 LACEY BLVD. SE
LACEY WA 98503
Contractor License No.:
Project Information:
Project: MECHANICAL
Description of Work: ADD AIR CONDITIONER
Sq. Ft. per floor: F t
i rs
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Permit No.: 20170193
Issue Date: 5118/2017
(Work must be completed within 180 days)
Phone: 512 - 993 -7740
Owner: DARYL GUTIERREZ
Subdivision: BELLA HOUSA VILLAGE Lot: 48
Expires
Phone:
0 /00 /0000
Heat Type (Electric, Gas, Other):
Contractor
SUNSET AIR 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 applyin as a contractor, I further certify that I am currently
registered in the State of Washington.
1
Signature Date
Firm
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of Mm
O ) 458 -3244
REC4: 00269853 5/19/2017 8 :16 AM
OPEF : CO TERM: 001
REF4: 35639
PAID BY:
TRAN: 33.0000 BUILDING PERMITS
20170193 29.5(CR
GUTIERREZ, DARYL & :HANNON
14727 91ST AVE SE
hIECH 29.5(CR
TENDERED: 29.50 (HECK
APPLIED: 29.50-
0.00
a 3
CITY OF YELM ��� 9 9 Zo(�ol
RESIDENTIAL BUILDING PERMIT APPLICATION FORM o
Project Address: 141a'l Cilk 7' VQ 54-- Parcel #: �,)��� MSD O
x
Subdivision: Lot #: Plan * Zoning:
�1 New Construction o Re -Model / Re -Roof / Addition ❑ Home Occupation Sign
❑ Plumbing Mechanical ,/❑ Mobiilr'eA/ Manufactured Home Placement C1 Other
Project Descriptions /Scope of Work: W 1
Project Value: ` 9ul
Building Area (sq. ft) 1st Floor 2nd Floor 3`d Floor Garage -2 car 3 car
Covered Patio Covered Porch Patio Deck
# 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.
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PIN
ADDRESS I
CITY STA
ADDRESS 11
CITY -- - - STATE
CONTRACTOR'S LICENSE #
ADDRESS
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CONTRACTOR'S LICEN E #
LICENSE #_
EMAIL
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TELEPHONE
EMAIL
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FAX - _
EXP DATE—CITY LICENSE #,
TELEPHONE
P FAX
EXP DATE CITY LICENSE #,
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CITY _S ATE�ZIP gb'V.Z1 FAX go'Lffils _
CONTRAC R'S LICENSE #mil At&J " 21Qtt?XP DATE CITY LICENSE #_
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Copy of mitigation agreement with Yelm Comnify Schools, if applicable.
I hereb certify that the above Information is correct and that the construction on, and the occupancy and the use of the
abo de cribed property wtll be In accordance with the laws, rules and regulations of the State of Washington and the
Cif of Y Im. oil
Appli ant's gidnature Date
Owner / Contractor f Owner's Agent I 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 period of 180 days
105 Yelm Avenue West (360) 458 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.ye1rn.wa.us