20170227 Permit Pkg 06082017City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458 -3144
Applicant:
Name: GRISELDA PEREZ
Address: 9977 DAIN ST SE
YELM WA 98597
Property Information:
Site Address: GG77 nAim ST SF
Permit No.: 201 70227
Issue Date: 6/08/2017
(Work must be completed within 180 days)
Phone: 281 - 790 -9088
Owner: GRISELDA PEREZ
Assessor Parcel No.: 78640115200 Subdivision: TAHOMA TERRA Lot: 152
Contractor Information:
Name: ALL SEASONS INC.
Address:
5001 N 28TH ST
TACOMA WA 98407
Contractor License No.: ALLSEI`03055
Phone: 253 - 879 -9143
Expires: 12/17/2018
Project Information:
Project: MECHANICAL
Description of Work: INSTALL AC 3 TON UNIT TO EXISTING FURNACE
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
ALL SEASONS 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 applying as a contractor, I further certify that I am currently
registered i tate of Washing � I�
Signature Date /
Firm R-1/
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Tl of C,
') 458 -3244
REC4: 00271222 610812017 :.:
OPER: CO TERM: 45 PM
001
REFA ;
PAIL' BY: DAVE
ACCT #: XXXXXXXXXXXXXXXXXXX
AUTFI #: 0583OZ
TRAP #: 000000000604
TYPE: PURCHASE
TRAP: 33.0000 BUILDING PERMITS
20 17022 7
PEREZ, GRISELDA
hIECH 29.5(CR
9977 DAIN ST SE
29.5(CR
1ENDERED: 29.50 CREDIT CARD
APPLIED:
29.50-
CHANGE: --
0.00
gZJq 0 J2 7
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 11717 %)a;h Sk SX-_ Parcel #: 786No tl Szoo
Subdivision: Lot #' Plan #: Zoning:
U New Construction ❑ Re -Model / Re -Roof / Addition C. Home Occupation Sign
❑ Plumbing Y Mechanical [:I Mobile / Manufactured Home Placement ❑ Other
Project Description /Scope of Work: AJ G 3 +01h ;v PJriSiilnq
Project Value: ZY tZ - $
Building Area (sq. ft) 1g` Floor MY 2 °d Floor TZ0 3`6 Floor Garage -2 car3'bo 3 car
Covered Patio Covered Porch 1-41 Patio Deck
# Bedrooms_ # Bathrooms 2 • Heating GA /OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? VIA
If yes, a completed environmental checklist must accompany permit application.
CITY 1i @Ihn _STATE W A —ZIP T %JS4 "__TELEPHONE V31 CM I - Zr-fa
ADDRESS EMA
CITY STATE ZIP�TELE
GEN.lRAL G`bNTRACTOi TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
P llIVIB1N0.'.CONTR;4CT0
TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANIC IL:; NTI ACTOF3 all 5914510 S, s� TELEPHONE t5 �' $'?°J'� 91 Yf
ADDRESS 91Q31 S w k; St EMAIL COnty44-4)s
CITY_ n*,"w#. _STATE 041114 ZIP SVO FAX S i S M S
CONTRACTOR'S LICENSE #al EXP DATEYj&CITY LICENSE # I - 11 0
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.
66
Applicant's Signature Date
Owner / Contractor I 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
j • 7
105 Yelm Avenue West (360) 455 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
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