20170308 Permit Pkg 09082017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: DAVID EATON
Address: 15523 104TH PL
YELM WA 98597
Property Information:
Site Address: 15523 104TH PL SE
Assessor Parcel No.: 62190000200 Subdivision:
Project Information:
Project: MECHANICAL
Description of Work:
Sq. Ft. per floor:
First
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL PERMIT
WHOLE HOUSE FAN /MISCELLANEOUS
Permit No.: 20170308
Fee Calculation Worksheet
Phone:
Owner: TYPE CURRENT OWNER
NAME
Heat Type (Electric, Gas, Other):
Units
1
1
TOTAL FEES:
PAYMENTS MADE:
BALANCE DUE:
Lot:
Fees
$ 20.00
$ 9.50
$ 29.50
$ 0.00
$ 29.50
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RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: �23 y—C �l Se Parcel #: U - 7 4 oOO zo 0
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 Word ns i i /l iC a I(.t I Q .0`j2CC. QU S turnaC-e
Project Value: n Sal l
Building Area (sq. ft) Vt Floor 2 "d Floor 3 d Floor Garage -2 car 3 car nKl ��
Covered Patio Covered Porch Patio Deck a
# Bedrooms # Bathrooms Heati : GA /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 AME:
ADDRESS Z tbq P11 S6 EMAIL
CITY STATE WR 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
CONTRACT R'S ICENSE # D P DATE ITY LICENSE # j '(
MECHANICAL CONTRACTOR VIA IbELEPHONE U
ADDRESS' EMAIL
CITY STATE ZIP FAX
CONTRA TO 'S L CENSE # bL&AS EXP DATE 4 CITY LICENSE # L 1070_
1laM
Copy of mitigation agreement with Yelm Community Schools, it 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 erty will be in accordance with the laws, rules and regulations of the State of Washington and the
Cit of Yelm.
to
Applicant's S' re Date
Owner / Con for / 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 Avenue West (360) 458 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.velm.wa.us
City? of Mm
(36 0)
458-3244
REC*: 00280606
9/08/2017 11:13 AM
OPEF: CO TERM: 001
REF*: 18864
PAID BY:
TRAM: 33,0000
BUILDING PERMITS
20170309
29.5(CR
BELL,
JACKIE
10428 GROVE RD SE
MECH
29.5(CR
TRAM: 310000
BUILDING PERMITS
20170308
29.5(CR
EATON,
DAVID
15523 104TH PL SE
MECH
&5(CR
TENDERED:
59.00 (HECK
APPLIED:
59.00 -
CHANGE: ----0,-00
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