20050428FROM :YELM SEWER DEPT.
~~
~~~~
TO: G~
FAX N0. :360-458-8166 Aug. 24 2006 04:58PM P1
FAX TRANSMXSSION
CXTY OF `YEI..M
P.Q. BOX 479 ^ 93 t NP ROAD N~;
YELM, WA 98597
360-~5$-$4] l
FAX 360-45$-S 166
c~l~N
~AG~S: ! ,including this
Cover sheet
From: ~~NO u
Subject: ~~ U.SE. ~ 1iU~}L, I~u ct~tl~o>2~ ~5"r
~~ ~ ~°~
_ ,~
1
** 11`you do roc receive all copies or any copy is not legible, please ca]l (3C~0) 458-8411
as soon as possibly.
FAX#:
.- ~
~ ~~
~!
k
~`
~~
F'
~sw..~._
/~ f j
.~~
~~`
~~
~~~v ';
,t a~
c
3...ef}
~ ,~
--
.4-~-;
c i
{
b~m.i
W Q
~ a
~ U
n. ~
0 ~
~ W
Z
~ U
m
~ W
(,~
W J
~ a
O W
V W
y
N
d
Q
rn
C_
.~
m
N
N d
(0 'p
Z Q
N N
C C
3 3
00
Z
c
m
a
Q~
~C
C
Z
.C
N
a
rn
C_
.0
.?
m
N
Q
y
C
O
C
O
U
m
.U
n
m
f0
fU
.U
O
rn
C_
._
m
W
Q. 3
L ~
U n
,.
m ~
c
U ° °o
_UN
co ° _
~o>,
-p U ~
~ rn~
° c y
~ v >
U
C m
O ~ ~
.~ ~
C w'
a; ~ U
° o~
~ ~N
w •C p
L tLq ~
c~
3~ c
m
~~~
N
~ ~~
~a ~
E~ N
O ~ `'
C O ~-
'y ° U
~{
/`
L Q
(n J
r
L ,
r
r--S
~~
:,
:~
~Y-ki
9rR';F
,,~;P
~3E
:!B'°'R
`'.
~~
~~%E
`. 'w.~.t
:~~-.-.,
~~ S
F !rY - .
~~
~"°: }
fi i
how.~sF
i
~`
r{' 1
r --
~~--,
~.,, ;
~ Fi
• ata~sd
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: Evergreen State Builders
Address: P.O. Box 39753
Property Information:
Site Address: 14852 89th Ave. SE
Assessor Parcel No. 37540001100
Gontractor Information:
Name: Evergreen State Builders
Address: P.O. Box 197
Contractor License No: EVERGS8980PB
Project Information:
Project: Buckhorn Estates
Description of Work: 174013 SFR, Lot 11
Sq. Ft. perfloor: (1st) 854 (2nd) 952
Heat Type (Electric, Gas, Other): GAS
Fees:
City: Lakewood
Permit Ivo: BLD-05-0428-YL
Issue Date: 12/27/2005
(Work must be started within 180 days)
Receipt No: 39535
Phone: 253.475.6622
State: WA Zip 98499
Subdivision: Buckhorn Estates
Contact: Medina, Ed
City: Lakewood
Expires: 10/02/08275
Lot: 11
Phone: 253-475-6622
State: WA Zip: 98499
Business License:
(3rd) 0 Garage 418 Basement 0
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Building Permit 100-500k 1,413.75 993.75 420.00 5.6000 75.0000 $1,000
Building Plan Review 597.30 0.00 0.00 0.0000 0.0000
Mechanical Permit 78.25 0.00 0.00 0.0000 0.0000
Plumbing Permit 118.00 20.00 98.00 7.0000 14.0000 Fixture
Sewer Inspection 145.00 0.00 145.00 145.0000 1.0000 ERU
Water ERU 1,500.00 0.00 1,500.00 1,500.0000 1.0000 ERU
Water Meter (SFD) 300.00 300.00 0.00 0.0000 0.0000
Water Deposit 40.00 40.00 0.00 0.0000 0.0000
Sewer Deposit 50.00 50.00 0.00 0.0000 0.0000
Traffic Facilities Charge 757.50 0.00 757.50 750.0000 1.0100 Peak PM Trip
State Building Fee 4.50 4.50 0.00 0.0000 0.0000
Fire District Impact Fee 480.38 0.00 480.38 0.2160 2,224.0000 square foot
Sewer ERU 5,417.00 0.00 5,417.00 5,417.0000 1.0000 ERU
TOTAL FEES: $10,901.68
Applicant's Affadavit:
OFFICIAL USE ONLY
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 # Sets of Prints:
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 futher certify that I am currently
registered in the State of Washington. Final Inspection: ,
~ Date:
Signature~Ir' _'„''~~ Date ~,1 ~ z 7•~ O
Firm ~S/~ By.
_. w
a ~'- _ ..:
n - - .. ~G
~.
~~a~' ... _____. __. ... .._.__. -.......__. _. _.. __. ... .__. __..._______
~" ~'~'~
- - _ _,
****TEN THOUSAND NINE HUNDRED ONE DOLLARS & 68 CENTS
_',_ i=y :_.. C "~,~ CAI E =,EC. NC. .4 ~r'~.',~."JT
EVERGREEN STATE BUILDERS 12/27/05 39534 10,901.68 CHECK
PO BO% 39753
LAKEWOOD, WA 98499 BUDGETARY
BLD-05-0427-YL
SITE: 14871 89TH AVE SE LOT 7
RE= `o
PENDING'
BLDPRMT1413.75, PLNREV597.30, MECHPRMT78.25, PLMB118, S/INS145. W/ERU1500
W/MTR300. W/DEP40, S/DEP50. TRAFF757.50. STFEE4.50, FIRE480.38 S/ERU5417
' 7,1F A~~A ~~ 1 3 VF
`~= ~ YELi'v1
~~ ~ a~x~y 39535
~~; __^~8 a;v;,z
~_ . ~ ~~_.
****TEN THOUSAND NINE HUNDRED ONE DOLLARS & 68 CENTS
RECE!`i=r' FRQ~v? i:i/=ATE REC. NQ. A. J ^_'?`~~
EVERGREEN STATE BUILDERS 12/27/05 39535 10,901.68 CHECK
PO BO% 39753
LAKEWOOD. WA 98499 BUDGETARY
BLD-05-0428-YL
SITE: 14852 89TH AVE SE LOT 11
.,-,
PENDING
BLDPRMT1413.75, PLNREV597.30, MECHPRMT78.25. PLMB118, S/INSP145, W/ERU1500
W/MTR300, W/DEP40, S/DEP50. TRAFF757.50. STFEE4.50. FIRE480.38, S/ERU5417
__ - -- --------V---------------------------- ---------------------- --- ---- ----
~~~~ ~~ :~~.kG~ ~~ R~cE~~T ~0, 3 9 5 3 ~
,;
****TEN THOUSAND NINE HUNDRED FORTY DOLLARS & 41 CENTS
EVERGREEN STATE BUILDERS
PO BO% 39753
LAKEWOOD. WA 98499
BLD-05-0429-YL
SITE: 14846 89TH AVE SE LOT 10
^vATE REC. NO A.'v?CN~"
12/27/05 39536 10,940.41 CHECK
BUDGETARY
=. ~c
PENDING'.
BLDPRMT1403.95. PLNREV593.16, MECHPRMT78.25, PLMB132, S/INSP145. W/ERU1500
W/MTR300, W/DEP40, S/DEP50. TRAFF757.50. STFEE4.50. FIRE519.05, S/ERU5417
YELM COMMUNITY SCHOOLS
PO BOX 476
YELM, WA 98597
Clerk: Gerber
Terminal: 1
Receipt: 12860
Manual Receipt:
EVERGREEN
2534756622
EVERGREEN STATE, BUILDERS LLC
12/27/2005 12:57 PM
Qty Item Price
1 CPF2900 5133.00
MITIGATION
Buckhorn Lots 7, 10, & 11
Subtotal: 5133.00
Tax: 0.00
Total: 5133.00
Check 5133.00
10996
Change Due: 0.00
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit Fees Schedule
Permit No: BLD-OS-0428-YL
Applicant:
Name: Evergreen State Builders Phone: 253.475.6622
Address: P.O. Box 39753 City: Lakewood State: WA Zip 98499
Project Information:
Project: Buckhorn Estates
Description of Work: 174013 SFR, Lot 11
Site Address: 14852 89th Ave. SE Assessor Parcel No. 37540001100
Fees:
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Building Permit 100-500k 032 001-322-10-00 1,413.75 993.75 420.00 v5.6000 75.0000 $1,000
Building Plan Review 100 001-345-83-00 597.30 0.00 0.00 0.0000 0.0000
Mechanical Permit 032 001-322-10-00 78.25 0.00 0.00 0.0000 0.0000
Plumbing Permit 032 001-322-10-00 118.00 20.00 98.00 7.0000 14.OD00 Fixture
Sewer Inspection 805 412-343-80-00 145.00 0.00 145.00 145.0000 1.0000 ERU
Water ERU 715 401-343-80-02 1,500.00 0.00 1,500.00 1,500.0000 1.0000 ERU
Water Meter (SFD) 712 401-343-80-01 300.00 300.00 0.00 0.0000 0.0000
Water Deposit 740 402-389-00-00 40.00 40.00 0.00 0.0000 0.0000
Sewer Deposit 742 402-389-01-00 50.00 50.00 0.00 0.0000 0.0000
Traffic Facilities Charge 420 120-345-85-00 757.50 0.00 757.50 750.0000 1.0100 Peak PM Trip
State Building Fee 160 001-386-00-00 4.50 4.50 0.00 0.0000 0.0000
Fire District Impact Fee 105 001-345-85-00 480.38 0.00 480.38 0.2160 2,224.0000 square foot
Sewer ERU 802 412-343-50-01 5,417.00 0.00 5,417.00 5,417.0000 1.0000 ERU
TOTAL FEES: 510,901.68
12/1912005 16:28
2532843183 CAS RES NWAF TDf~I PAGE 02
I /tit 14
SITE PLAN A
r~ ~~~
25° - 40' 7 9'- T 1.74"
72.51'
BCD 6
~ ~I o ~
a '~
Q ~ e--
~ ~ ~ ( \
~ ~ ~ ~ ~~
N /
j,,, 6' '~S81. ~Ntl'H~dA6
76.47'
5,~~
1
l
~~` ~
~p~-
~~
~~
~~.
P
~~
~~
,'~ ~ t: .~.... ~ ...
NORTH
~ 2pOS CASCADE f2ESIDENTIAL [7ESIGN, INC_ SCALE I~ = 2OI
THIS DRAtWNF l4 RARFO AN CWFNT-PR1fVIDEb INFOkMATgN REPRESENTED TO RF. ACCIIRAT6
AND RELMRI,E• ANY p~;.Y,REPANCIEv PETWEEN THIS DRAWING AND THE ACTUAL RITE, CONMAON$
ARE THE SOLE RFRPONRIpH,RY OT TFIE G.IENT,
d.1}~
E~IERGREEl"~ ST,.ATEr BLT~LI~~R.S
avc~aRN ESTA'!'F~
14858 89th AVENUE SOUTl~:~iSI~
PPR~YAL ~N COUIV~"~~ WA
PARCEL Na. 37540001100
i+i ~ ~ Vt T CLM
R~IDENTIAL BtlitDlMG PERMIT~A~PrPLICA_` ~ V FOiRM
Project Address:~~~~~, o°~~frd~ % ~t~ercet #: //yD`.~ _ ,~
Sutxiivision:~711r'~? ~ ~, ,~'~ ~ ~ _ ~~~, f ~~
.^ Lot #:~ ---_ Zoning; QS_=~ ~ ~~~~~~¢`~.~.,~~' ®d/~
,,, 1~ ~
ew Construction a Re-Model J Re-Roof 1 Addition ~ Home Occupation Sign lp~s
U Plumbing U Nlechanicat U Mobile /Manufactured Home Placement U Other
Project DescriptioQN~ Scope of Work `-~~ ~~' ~~-~.1~ru..~,~ ~~Q<~1~~~' ~~~
Project Value?`~° ~~~ y,_,S~C~ G
//
Building Area (sq. ft} 1'` F1oor~`l~ z^~ Floor S~ Garage yip Deck O
Basement Carport Patio z~~
# Bedrooms # Bathrooms~J Heating~~~3THER or ELECTRIC (Circle One)
Are there any ernrironrnentaily sensitive areas located on~t~-h-e---p''arcel? 1f yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER NAME'~~~r~~..~y~ cramp >,' BPS ~,~
ADDRESS --- ~ EMAIL ~'~da ,'- ~ Q~I~.aPS7/-, ,,~Gt~`'
CITY ~t1 v`a~-~^STATEL~ Zlp ~'~ TELEPHONEC~-~3?'C,~7~ ~ t~Z ~
ARCHITECTIENGINEER C"S t'~ fCENSE #
ADDRESS d~ ~ ~ EMAIL
CITY ~ a_STATE ~-G ZIP G~ TELEPHONE CZS ;~ ~ ~' 1~ -~ /-7t-;
GENERAL CONTRACTOR CL~t..~u ~~.~~.2yo-~ TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # ~'f/~v ~G% ~"~ EXP DATE ~~7 CITY LICENSE #
PLUMBING CONTRA TOR `~ ~c.t'Z Ik.~ ELEPHONE_~~5~,~ .->.--~ 7- ~jO~j
ADDRESS f`~f~ ~ -~~ G EMAIL
CITY fGt''~~?.~. _STATE s.~,t~- ZIP ~ FAX L~3~ .3~°.~ ~~t~ -~
CONTRACTOR'S LlCIENSE # EXP DATE CITY LICENSE # i
MECHANICAL CONTRACTOR ~ - `~ TELEPHONE ~Z..~3 ~"
ADDRESS ~ ~c~.,,~ ~- ._ EMAIL
CITY f _STATE C.-C.~ ~-~-FAX
CONT CTOR' LICI=NSE # EXP DATE CITY LICENSE #
Copy Qf mitigation agreement with Yetm Community Schools, if applicable.
! hereby oeriify that the above information is con-ect and that the construction on, and the occupancy and the use of the
above descrtbed property will be #n accordance with the laws, rules arxf regulations of the State of Washington and the
~-/~ O~~
Dots
E?wner I Contractor /Owner's Agent !Contractor"s Agent (Please circle one.)
Att permits are non-transferable and will expire if worts authorized by such permit is not begun
within 180 days of issuance, or if work is suspended or abandoned for a period of 1811 days
103 Yelm Avenue Weat
PO Box 479 (360) 435-8833
Yelm, N'A 85597 (360) 438-3t~I FAX
u+utao.ciyelnr.a;o. ue