20170194 Permit Pkg 05182017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20170194
Issue Date: 5/18/2017
(Work must be completed within 180 days)
Applicant:
Name: ERIC & JILLIAN CODAY Phone: 360- 350 -2086
Address: 9939 BOURBON ST SE
YELM WA 98597
Property Information:
Site Address: 9939 BOURBON ST SE Owner: ERIC CODAY
Assessor Parcel No.: 84070008100 Subdivision: WILLOW GLENN III
Contractor Information:
Name: ERIC & JILLIAN CODAY Phone:
Address:
9939 BOURBON ST SE
YELM WA 98597
Contractor License No.: Expires: 0 /00 /0000
Project Information:
Project: MECHANICAL
Description of Work: INSTALL AIR CONDITIONER
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
ERIC & JILLIAN CODAY
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
registered e S of Washington.
Signature Date
Firm el e
Lot: 81
Fees
$ 2950
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date.
By:
City, of Yelm
(36 ) 458 -3244
RECD: 00269840 5/1812017 5:51 PM
OPER: CO TERM: 001
REFS: 13918
PAID BY:
TRAM: 30.0000 BUSINESS LICENSE
17% PACIFIC AIR HEATIPG & AC
BUSINESS LICENSES & 25.000R
TRAM: 33.0000 BUILDING G S(CRITS
20170194
CODAY, ERIC & JILLIEN
9939 BOURBON ST SE
MECH 290CR
IE.NDERED: 64.50 (HECK
APPLIED: 64.50 -
CHANGE: 0.00
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: IY31 �A? 4,�A -,V c�%�S Parcel #: Y��- 7,c;,c2y Jr/4--,c;7
Subdivision:
Lot #: Plan #: Zoning:
New Construction Re -Model / Re -Roof / Addition Home Occupation Sign
i Plumbing 1> "Mechanical ❑ Mobile / Manufactured Home Placement Other
Project Description /Scope of Work:
Project Value
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? / 111
If yes, a completed environmental checklist must accompany permit application.
BUILDING OWNER NAM : .(' /G v
ADDRESS tl� dJ EMAIL
CITY �f�t, STATE ZIP TELEPHONE
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR &P /G / TELEPHONE 9 (✓95f" ` % ` Lr
ADDRES EMAIL s vyty!
CITY r !/ - STATE IP �% FAX
CONTRA T R'S LICENSE #1>A���.+�,If�S�t7.�itEXP DATSi �,LITY LICENSE #
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.
A Icant's Signature Date
caner / 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 if work is suspended or abandoned for a period of 180 days
a ,'/ e�xr,,,f
105 Yelm Avenue West (360) 458 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.yelm.wa.us