20170291 Permit Pkg 08182017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: DAWN CHISHOLM
Address: 9314 PRAIRIE WIND ST SE
YELM WA 98597
Property Information:
Site Address: Q31A PRAIRIE WINfI CT CF
Assessor Parcel No.: 64410002300
Contractor Information:
Name: BRENNAN HEATING
Address:
4601 S 134TH PL
SEATTLE WA 98168
Contractor License No.: 10111
Project Information:
Project: MECHANICAL
Description of Work:
INSTALL 3 -TON AC UNIT
Sq. Ft. per floor:
First
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Permit No.: 20170291
Issue Date: 8/18/2017
(Work must be completed within 180 days)
Phone: 303 - 594 -7598
Owner: DAWN CHISHOLM
Subdivision: MCMENZIE MEADOWS
Expires
Phone:
12/31/2017
Heat Type (Electric, Gas, Other):
Contractor
BRENNAN HEATING
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 in the State of Wa Vhington. Signature CviL u� Lu � Date
Firm fk.cA --t A C
Lot: 23
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City, of Yell
(36 1 458 -3244
RECA: 00279182 8/18/2017 1:59 PM
OPEE;: ASHCO TERM: 001
REFS: 46759
PAID BY:
TRAM: 33.0000 BUILDING PERMITS
20170291 290CR
CHISHOLM, DAWN
9314 PRAIRIE WIND Sl SE
MECH 290CR
TENDERED: 29.50 (HECK
APPLIED: 29.50-
CHANGE: 0.00
8` ILK /7
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLI S cION FORM
Project Address:Q ,) �r +a t i t 'L t Parcel# Lo q 1 bb0 P 3 c)c)
Subdivision: Lot #: Plan #: Zoning:
New Construction Re -Model / Re -Roof / Addition Home Occupation Sign
r Plumbing ✓ilechanical Mobile / Manufactured` Home Placement Other
Project Descriptior- Scope of Work:) {ri �� < < - -1'I:�) r-\ G-
Project Value:
Building Area (sq. ft) 151 Floor 2" Floor Garage Deck
Basement Carport Patio
# 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.
OR M
BUILDING OkVNER NWE: -s. K t O-C
ADDRESS 31 -A - r i A- W 1 EMAIL
CITY STATE W O- ZI �TELEPHONE 98
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 -4,r_ yam- TELEPHONE Qk- IB . O�
ADD S O\ S \ "pl, EMAIL - c Q prI-�
CITY � STATE W e.. ZIP FAX O� • t5 �� 00
CONTRAC OR'S LI ENSE # EXP DATE, Cl Y LICENSE #
v..r. q a 6( 1-4-
Copy of mitigation agreement with elm Community Scho Is, if applicable.
I here9�ly certify hat the above information is correct and that the construction on, and the occupancy and the use of the
abo a describe property will be in accordance with the laws, rules and regulations of the State of Washington and the
ci of Yelm.
�-
Ap "it's Signature Date
06wi§r / Contractor / 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 o 0 IV
IT va
U6 1 2017
105 Yelm Auenue West (360) 35
Yelrn, WA 98597 (360) �l 8-,- 1�'9'PAK-------- - - - - --
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