20170275 Permit Pkg 08042017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: YELM VISION CLINIC
Address: PO BOX 2990
YELM WA 98597
Property Information:
Site Address: 203 YELM AVE W
Assessor Parcel No.: 85800300100 Subdivision:
Contractor Information:
Name: A PLUS SERVICES
Address:
7225 PACIFIC AVE SE
OLYMPIA WA 98503
Contractor License No.: ALECS*994NO Expires
Permit No.: 20170275
Issue Date: 8/04/2017
(Work must be completed within 180 days)
Phone: 360- 458 -2088
Owner: YELM VISION CLINIC
Phone:
8/29/2017
Project Information:
Project: MECHANICAL
Description of Work: INSTALL AC ROOF TOP UNIT
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
A PLUS SERVICES
TOTAL FEES:
Applicant's Affidavit:
certify that I,lhave read and examined the information contained within the application and know the same
to be true a d correc t- 1-afso certify that the proposed structure is in conformity with all applicable City of
Yelm regul ions including tho? a governing zoning and land subdivision, and in addition, all covenants,
easements nd re trictions t:py contractor, I further certify that I am currently
registered i the to of W
Signature Date
Firm
Lot:
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
C i of deli
(36 +) 458.3244
RECk: 00277062
OPEF: ASHCO TERM: 810412011,-1
REFA, 037315 001
33 PM
PAY BY:
TRAP!, 33.0000 BUILDING PtRM17,,
20170275 29,5(
VELM VISION cl' N,[c CR
203 YELM AVE N
MECH ,
29,5(CR
IENDERED: 29,50
APPLIED: (HECK
29.50-
(HANGS: ----
0,00
AW
EN
1ASHING'
41-1-1
BUILDING PERMIT APPLICATION
_!i / r
❑ New Construction (SFR) ❑ Remodel
0 Mechanical
❑ New Construction (Duplex) ❑ Addition
❑ Commercial
❑ New Construction (Multi - family) ❑ Reroof
❑ Tenant Improvement
❑ Manufactured Home Placement ❑ Plumbing
❑ Fire Permit
Property Address: ald 3
$S8o
o3 00 Z�o
Tax parcel number: 9goa zo ysq t ,
r
Subdivision:
Lot No.:
Project Description /Scope of Work:
Project Value:
Heat Source:
�R Gas ❑ Electric ❑ Solar
Plan No.: Bedrooms:
Baths: 0
Area 1" Floor: rtS�j��vv�
2nd Floor:
3rd Floor:
Garage:
Basement:
Carport:
Covered Patio:
Front Porch:
Applicant:
Owner:
Address:
Address:
Telephone:
Telephone:
Email:
Email:
Architect /Designer:
General:
q—r 2YUlceS T6
Address: 7 P011G1+ 1c
License No.:
Telephone: Llk c._ WC -
Telephone:
366 'fit �1�1f ��Od
�
Email:
Email:
Plumber:
Mechanical:
Email:
Email:
JUL 3 ? 20171
License No.:
License No.:
By submitting this application to the City of Yelm, you affirm that all answers, statements, and information
contained in and submitted with this application are complete and accurate to the best of your knowledge and
that you are the owner of the property or duly authorized by the owner to act on their behalf. Permission is
granted to representatives of the City to enter upon and inspect the property as reasonably necessary to process
the application.
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