20170269 Permit Pkg 07252017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 201 70269
Issue Date: 7/25/2017
(Work must be completed within 180 days)
Applicant:
Name: JAMIE & YATSU MCCLOUD Phone: 360- 250 -9535
Address: 15412 92ND AVE SE
YELM WA 98597
Property Information:
Site Address: 15412 92ND AVE SE Owner: JAMIE MCCLOUD
Assessor Parcel No.: 41610009300 Subdivision: CHERRY MEADOWS
Contractor Information:
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:
certify that I have read and examined the information contained within the application and know the same
to be true d correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regu tions including those governing zoning and land subdivision, and in addition, all covenants,
easement an of record. If applying as a contractor, I further certify that I am currently
registere in th tate of W hington.
Lot: 93
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite 14518e -32 (36I-3244
RECA: 00276260 7/25/2017 '3:49 PM
OPEP: CO TERM: 001
REFA: 13972
PAI[l BY*
TRAM: 33.0000 BUILDING
29 iRMIT3
20170268
FARNSWORTH, DALE & :HARON
14852 99TH AVE SE
9.5(CR
MECH
TRAM: 33.0000 BUILDING 5(CRIl3
20170269
MCCLDUD, JAMIE & YA1SU
15412 92ND AVE SE
MECH 29.5(CR
TENDERED:
59.00 (HECK
PPPLIED:
59.00 -
CHANGE:
0.00
`. i
CITY OF YELM a07O q
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: /Sg /2 2nd AV�E 5;e Parcel #:
Subdivision: Lot #: Plan #: Zoning:
New Construction C Re -Model / Re -Roof / Addition ❑ Home Occupation Sign
Plumbing �< Mechanical 7 Mobile / Manufactured Home Placement Other
Project Description /Scope of Work: 11V%5 i At-L- 4112 COIL L)1 7_16NE2
Project Va
Building Area (sq. ft) 1s` Floor 2nd Floor 3rd 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?
If yes, a completed environmental checklist must accompany permit application.
BUILDING OWNER NAME: J-,4A41 titeC��La�
ADDRESS 9�2Acl kVE Ge EMAIL
CITY y`%t,/U STATE w, ZIP -7 TELEPHONE 3 &C
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 f4c -Ir-l` ,k-h2 �-}-a- i4ffELEPHONE 3! X57 -�32
ADDRESS :�_-7,Z7 4 EMAIL
CITY Oi-VA) n« STATE LtJ� ZIP gfrT FAX
CONTRACTOR'S LICENSE # 94c/ f4/ +*,5LyEXP DATE 6 l 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 of Yelm.
4 1 ' ��� 7-)-o -17
Appli a nature Date
Owner / o ractor 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
105 Yelm Auenue West
Yelm, WA 98597
www.ci.yelm.wa.us
E JUL 2 4 2011 IJ
(360) 458 -3835
B--------------- 60) 458 -3144 FAX
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