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20170268 Permit Pkg 07252017Applicant: City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458 -3144 Permit No.: 201 70268 Issue Date: 7/25/2017 (Work must be completed within 180 days) Name: DALE & SHARON FARNSWORTH Phone Address: 14852 99TH AVE SE YELM WA 98597 Property Information: Site Address: 14852 99TH AVE SE Owner: Assessor Parcel No.: 78640005700 Subdivision: TAHOMA TERRA Contractor Information: 541 - 656 -9551 DALE FARNSWORTH Name: PACIFIC AIR HEATING & AC Phone: Address: 2727 MARTIN WAY E OLYMPIA WA 98506 Contractor License No.: PACIFAH908LP Expires: 6/30/2018 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 PACIFIC AIR HEATING & AC 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 c rrect. I also certify that the proposed structure is in conformity with all applicable City of Yelm regulatio including those governing zoning and land subdivision, and in addition, all covenants, easements an res ecord. If applying as a contractor, I further certify that I am currently registered in tj St e f a ington. .� c Signature Date ��dy'� Firm Li KL �4'�tr� s R l✓ Lot: 57 Fees $ 29.50 $ 29.50 OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: � �u1 - 458 3 244 (�v` - RECA: 00276280 7/25/2017 3:49 PM OPEP: CO TERM: 001 REFt: 13972 pAI[i 0Y: TRAN` 33.U00U BUIU)ING P\RMITS ' 29 �CH 2,0170268 . . DALE & '�HAR[N 14052 99TH AVE SE N�CH Z9 �CR . TRAN' 33.0OOO BUILDING P[RMIl3 ' 2U1702b9 �9 5(CK . MCCLOUD , YA] JAMIE & GU — 15412 92ND AVE SE MECH 29 5(CH TENDERED: 59.00 [HECK — 00- APPLIED: 59.00- [HANG[: v. u" Sri 03,V-6' CITY OF YELM RESIDENTIAL BUILDING PERMIT APPLICATION FORM Project Address: /41' g2 ? —?k ��e 5C Parcel #: 796 qo0 ©S'% O C1 Subdivision: Lot #: Plan #: Zoning: New Construction Re -Model / Re -Roof / Addition - Home Occupation Sign Plumbing %, Mechanical Mobile / Manufactured Home Placement Other Project Description /Scope of Work: 11V5794 +L.L A/2 Ce1AJ)1 7o^J 2 Project Value: Building Area (sq. ft) 1" Floor 2nd Floor 3 d Floor Garage -2 car 3 car Covered Patio Covered Porch Patio Deck # Bedrooms_ # Bathrooms_ Heati : GAS /�THER or ELECTRIC (Circle One) Are there any environmentally sensitive areas located on the parcel? If yes, a completed environmental checklist must accompany permit application. BUILDING OWNER NAME: blk-Lc S 1-J02 TN ADDRESS 141S_-q4 OP 4. LI-✓F Sc EMAIL CITY Yiff-M STATE WA ZIP 9L _TELEPHONE S'q /- orb -yss� ARCHITECT /ENGINEER LICENSE # ADDRESS EMAIL CITY STATE ZIP TELEPHONE GENERAL CONTRACTOR AIA 41*44 k— TELEPHONE 3(c0 - 357-4-445, ADDRESS 2717 1'4,412 r1ti' a,41 e EMAIL CITY STATE W4 ZIP G/'ilSc FAX 3,C-- ti1S CONTRACTOR'S LICENSE # Pft[aFz4j4f0BLPEXP DATE_Y14CITY LICENSE # 7 /:9 � 7 PLUMBING CONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # MECHANICAL CONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE CITY 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 aof Yelm. AppIWanVs- Sij*at *kre Date Own' ontractor P 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 per'O.days L jc C� J� I L 105 Yelm Auenue West (864 -45,8- 3835_____________ Yelm, WA 98597 (360) 458 -3144 FAX www.ei.yelm.wa.us