20170228 Permit Pkg 06092017f' ov THFP City of Yelm
q Community Development Department
4 En
Building Division
Phone: (360) 458 -8407
L
Fax: (360) 458 -3144
Applicant:
Name: MARGIE JEWELL
Address: P.O. BOX 245
YELM WA 98597
Property Information:
Site Address: %in MrKFN71F AVF SW
Assessor Parcel No.: 75300801300 Subdivision:
Contractor Information:
Name: WASHINGTON ENERGY SERVICES
Address:
3909 196TH ST SW
LYNNWOOD WA 98036
Contractor License No.: 10807 Expires
Permit No.: 201 70228
Issue Date: 6109/2017
(Work must be completed within 180 days)
Phone: 360- 458 -7353
Owner: MARGIE JEWELL
Lot:
Phone:
12/31/2017
Project Information:
Project: MECHANICAL
Description of Work: REPLACE GAS WATER HEATER
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
WASHINGTON ENERGY SERVICES
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 regulati (,e s including those governing zoning and land subdivision, and in addition, all covenants,
easements a rMofWas cord. If applying as a contractor, I further certify that I am currently
registered in gton. G
Signatur e Date �(
Firm `�� tJfL OY ✓J
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of Ni
(36 1) 458 -3244
REC4: 00271386 6/09/2017 :11 pM
OPEF: AS TERM: 001
REFS: 3933
PAIC BY:
TRAN: 33.0000 BUILDING PfRMIT',
20170228 29.5(CR
JEWELL, MARGIE
310 MCKENZIE AVE SW
hiECH 29.5(CR
TENDERED: 29.50 (HECK
APPLIED: 29.50 -
CHANGE: -- - - -� -- `-
0.00
A0170 I V
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: 310 SW McKenzie Ave Parcel #: 75300601300
Zoning, Current Use: Proposed Use:
New Construction Re -Model / Re -Roof / Tenant Improvement
Plumbing Mechanical Fire Prevent/Suppress /Alarm Other
Project Description /Scope of Work: replacing gas water heater
Project Value: 1500
Building Area (sq. ft) Parking Garage 1st Floor 2nd Floor 3rd Floor
Building Height
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER/TENANT NAME:
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
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 Washington Energy Services TELEPHONE 206- 378 -6927
ADDRESS 3909 196th StSW EMAILeonat @washingtonenergy.com
CITY Lynnwood STATE WA ZIP 98036 FAX
CONTRACTOR'S LICENSE # WASHIES851NS EXP DATE G7/17 CITY LICENSE #
Copy of City Mitigation documentation (TFC).
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. n
06/06/17
Applicant's Signature I Date
Owner/ Contractor/ Owner's Agent/ Contractor's Agent/ Tenant (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 f work is suspended or abandoned for a period of 180 days
(360) 458 -3835
105 Yelm Aue W (360) 458 -3144 FAX
Yelm, WA 98597 www.ci.yelrn.wa.us