20170162 Permit Pkg 05312017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: MARIE ANDERSON
Address: 114 NW CIRCLE VIEW DR
YELM WA 98597
Property Information:
Site Address: 114 CIRCLE VIEW DR NW
Assessor Parcel No.:
Contractor Information:
Subdivision:
Name: ADVANCED FILTER AND MECHANICAL
Address:
910 VALLEY AVE NW
PUYALLUP WA 98371
Contractor License No.: ADVANFM044RD
Project Information:
Project: MECHANICAL
Description of Work:
INSTALL HEAT PUMP
Sq. Ft. per floor:
First
Second
Third
Garage
Basement
Permit No.: 20170162
Issue Date: 5/31/2017
(Work must be completed within 180 days)
Phone: 360- 628 -3671
Owner: MARIA ANDERSON
Phone:
Expires: 12/29/2014
Heat Type (Electric, Gas, Other):
Fees:
Item Contractor
MECHANICAL ADVANCED FILTER AND MECHANICAL
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 ontractor, I further certify that I am currently
registered i the State of Washi gton. 2 /
Signature Date 7 /. t
Firm
Lot:
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Zof 70i` � Z--
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM j
Project Address: �1`'1 ck P ?' Parcel #: V 0"MU -) 1��00()
Subdivision.
Lot #: Plan #: Zoning:
New Construction -Model / Re -Roof /Addition Home Occupation Sign
Plumbing Ire'
echanical Mobile / Manufactured Home Placement Other
Project Description /Scope of Work: Wf,,�Q Zff t
Project Value:
Z
Building Area (sq. ft) 15` Floor 2nd Floor 3rd Floor Garage -2 car 3 car
Covered Patio Covered Porch Patio Deck
# Bedrooms_ # Bathrooms_ Heating: GAS /OTHERAorr ECTRIC ircle One)
Are there any environmentally sensitive areas located on the parcel? Vy
If yes, a completed environmental checklist must accompany permit application.
WA
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 CONTRACTOR ;( P)ek*`('L-VI�CqUt TELEPHONE
ADDRESSCOV4,140A L EMAIL
CITY J STATE M-,-ZIP FAX`u - �?c-- -'Zc-
CONT AC OR'S LICENSE #t 60',/041fftt fwMXP DATEVzXICITY 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 ofYelm. � I �tSO✓� «����
Applicant's Signature Date
Owner / Contractor / 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
Yelna, WA 98597 (360) 458 -3144 FAX
www.ci.yehn.wa.us
Address:
Job Description:
114 NW CIRCLE VIEW DRIVE
JASON &MARIE ANDERS
YELM WA 98597
AC /Furnace
nw circle view dr
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Site Plan Key:
-Main electrical panel
0 Transfer switch
QGasmeter
Back Yard
F—lGenerator
xElectricmotor
��� Wall mount ID unit
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Cite of Mm
(36 ) 458 -3244
REC0 00270314 5/31/2017 2:41 PM
OPEP: CO TERM: 001
REFS: 2522
PAID BY:
TRAM: 33.0000 BUILDING PERMITS
20170162 290CR
ANDERSON, MARIE
114 CIRCLE VIEW DR PW
MECH 290CR
1E:NDERED: 29.50 (HECK.
APPLIED: 29.50-
CHANGE: O.UU