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NEW CONSTRUCTION
WATER INSPECTION
DATE: 7 // g /d (o
DEVELOPMENT:
~_~1~~r~ ~~-
LET # ~~~
LOT # _______
LOT # ______
FROM :YELM SEWER DEPT.
4~0~ sHa „~
a ~
YELM
W.AtlMfNOTON
FAX N0. :360-458-f3166 Jul. 18 2006 04:55PM P1
FA.X TRANSMISSION
CITY ()F YL:LM
P.O. BOX 479 - 931 NP ROAD NI/
YI/L,M, WA 98597
360-458-84] 1
~~ rAX 360-4588166
~r
TO: CS (~ C ~N
FAX#:
Fram: ~~~~/~~~~'
DATE: 7~-1 bra ~
PAGES: ~ ,including this
Covelr sheet
Subject: }-~~ gas E '~ ~~~ ~~/ C3 ~,et~. N~(zN ~5 ( .
YY~ t LL, ~o~)ll ~a
~~3~~~
COMMI?NTS: z. o~ 7, J ~ ~ 71 ~~~~ ~ v ~: ~. C . ~ L'~ C
~i
'"* if you do not receive all copies or any copy is riot legible, picase call (360) 458-841 l
as soon as possible.
• CITY OF YELM INSPECTION LOG
PROJECT
`~U
f
PER'~11T'~U~1BER ~ S` ~~p`2 7
ADDRESS/ ~ g 7 ~ ~ ~ ~ ~K
SET B:~CtiS Date: ~~L /~2 ~~ 8
Front 2?~
Rear ~.
SideFlar.Linc
Side
FOOTI:~'G \\'ALL
~ 12" ~ 6•,
^ 16'' ~ g•,
other D other
required ~~ents
FOOTIIC REB.-~R Qt. Date: /~`~ g \\'.aLL REB.aR •O~ Date:~a ~J
rnmmPntc
O~IBI\ED FRa'~tE/ E\TER10R SHE.aR \1'.aLL I\SPECTI ~`
~`~~ 1 Ok Hold do~~ns ~ chear:~'ailine ~~~
,ap/ l ~,,, Frar~e "`~ ~ zJ Gas'Pmpane~. 3-- 20
~~//''~. u~i ~j~~C Plur~l,inc ~~ _ 3_ zc~ 'Mechanical ~ ~_ ~,~
j
"-` Comments
1\Sl'L.-\T10~` ~ Gas
'? Foam and Seal
Comments ~/~
SHEET ROCIC,'SHE.aR \\'.-\LL ~.aIL
Electric ~' Other
Vapor r~arrier = p\',-~
Comments n/n ~-',~, ~,~~~~
OTI~ER
Comments
11`,.~ L
Se~~er Final ~ Electrical
.address ~ Insulation
J Cis it Final ~ Landscape Final ?~ C cf 0
Site Drainace ~ide~~alk
Comments SOIL. 7/) ~
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: 14871 89th Ave. SE
Assessor Parcel No. 37540000700
Contractor Information:
Name: Evergreen State Builders
Address: P.O. Box 197
Contractor License No: EVERGSB980PB
Project Information:
Project: Buckhorn Estates
Description of Work: 1740/3 SFR, Lot 7
Sq. Ft. perfloor: (1st) 854 (2nd) 952
Heat Type (Electric, Gas, Other): GAS
Fees:
City: Lakewood
Permit Ivo: BLD-05-0427-YL
Issue Date: 12/27/2005
(Work must be started within 180 days)
Receipt No: 39534
Phone: 253.475.6622
State: WA Zip 98499
Subdivision: Buckhorn Estates
Contact: Medina, Ed
City: Lakewood
Expires: 10/02/06275
Lot: 7
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: 510,901.68
Applicant's Affadavit:
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 futher certify that I am currently
registered in the State of Washington.
Signature `~j~~ Date ~'~ •,Z7~OS
Firm ~,,,r/~
# Sets of Prints:
Final Inspection:
Date:
By:
- -
a_ .'.. 'e l~.C _ _.
~°-~ CITY OF
~~~' yr,_,~, YLL~~~
~~~ ~~ G ~ % RECEIPT No..3 ~J ~ 4
~; ~ ice. r .7.
****TEN THOUSAND NINE HUNDRED ONE DOLLARS & 68 CENTS
cl:E!~i'=~ ±=ROPS DAB E REC. NG. AMCLNT
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
FE+= NC.
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
~~~~'~ CITY~OF
/ ~.
'y~~ YELIVI
V Imi 1h/~~ 98597
~ ~ VOX 47~ RECEIPT N0, 3 ~ 5 3 5
>~
~°~~: 58-8403
cc ^'-, ,F
_'J = t'J .
****TEN. THOUSAND NINE HUNDRED ONE DOLLARS & 68 CENTS
RE'~-=!VED rRi7N1 DATE REC. NQ. A't1C'~NT
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 it
RE- ^i0
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
.. .: -• -.
'~ T'iFP,,~ CITY OF
~~~~ YELM ,.
a 4. Bo> 479 r
~~ ~ im `fvA 9ss97 RECEIPT No. 3 9 ~ 3 6
x~z.~wt... c~ -458 _403 ~
REv~.'~.`~~
****TEN THOUSAND NINE HUNDRED FORTY DOLLARS & 41 CENTS
RECEi',lED !!=RGtv1 DATE R.C. NO. AMOUNT
EVERGREEN STATE BUILDERS 12/27/05 39536
PO BO% 39753
LAKEWOOD, WA 98499 BUDGETARY
BLD-05-0429-YL
SITE: 14846 89TH AVE SE LOT 10
R,EF. NO.
10,940.41 CHECK 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-0427-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 7
Site Address: 14871 89th Ave. SE Assessor Parcel No. 37540000700
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 -----------
5.6000 ----------
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 14.0000 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!1612@@5 18:@5 2532843183 CAS RES NWAF ~'M PAGE @3
'1'F1URS1,'ON COUN'PY, 9VA ~~~
PA,RC~Z N0.375~OOU700 OF ~`j
LG~T ~
EV~,~.G~~N ST1~TE BU~,,D~R~
SUC~HORN ESr'ATES
148TH, $8th AVENNUE SOL1'THEAST
89ih AVE. SE
J i _ s3.ao'
~ ~ url~. esMr.
~~15' SBL_y~ rv
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~ PLAN 1740/38
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T1A>, DESIGN,
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'NIS CgAWINO IS RMEd ON CLIENT-PROV7bE6 INFORIAATIQN REPREliENTEb Tb 9E ACCURaTf,
1N0 RR,GA9LE. ANY dIiCREPANClES 9ETWREN 'MIS ~RAWINO ANIi THE ACTUAI, FITE CbND1T~dN5
kRF TpE ALE RFRpQN51@ILRY BF THE CLIENT,
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPL1Cl~ ,N FORM
Project Address:~/i v~S~ ~ ~r6r ,,,sue' ~#: /7!fd ' ,~
Subdivision:~~~~)~>'f S Lot #: `7 Zoning; o~pi,~tcl~ ~
U~IVew Construction ~~~~~~~
tJ Re-Mode! / Re-Roof !Addition u Home Occupation Sign
U Plumbing U Mechanical U Mobile /Manufactured Home Placement U Other
Project DescriptioNScope of Work:__ ~.~ ~~ -~GtDn.~~~ ,~Q~~~~~~
Project Value: ~ ~S~ Svl-4
v
Building Area (sq. ft) 1~ Floor ~j{ 2"~ Floor SZ Garage 5~/v~ Deck v
Basement Carport Patio 2/G ~/
# Bedrooms 3 # Bathrooms~S Heati :GAS! THER or ELECTRIC (Circle One)
Are there any environrnentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER NAME:~~f~ ~~~.fiD ~ S ~
ADDRESS 4-. _ ~ ~- S~eJ ~~ ,~ EMAIL i~'~. ~c}~~5~, ~
CITY ~~P _STATEI~ Z!P ~f ~'Yq~~ TELEPHONEG7,-s 3? X75- -~ ~vZ
ARCHITECT/j=NGINEER SC's ICENSE #
ADDRESS /Uv~ .SU v`Z EMAIL
CITY~~~_STATE iZIP U TELEPHONE_CZS3~7_Ssz/- ~/~~
GENERAL CONTRACTOR_ S'C~~,c.:pu ~ oGe-1c_~ TELEPHONE
ADDRESS EMAIL
CITY _STATE ZIP FAX
CONTRACTOR'S LICENSE # eV '(' EXP DATE o7 CITY LICENSE #
PLUMBING CONTRAi"TOR ~C-1'l %lt_Q ELEPHONE_Cz5~7 .~~ I~CC~
ADDRESS_/`~f ~' EMAIL
CITY lQ~y7 ~.- STATE u~- ZIP_~~FAX L~g~37 .~~ --{7(p -' ~i
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR ~`~ ~ 'TELEPHONE LZS"'~~~~ ~=; Q
ADDRESS S ,, ^~/~~r ~- - EMAIL
CfTY P _STATE ZIP .33 FAX
CONT CTOR' UCl~NSE # EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable.
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 Ye1m.
7
Applicant's Signatur~a
Owner 1 Contractor l Owner's Agent 1 Contractor's Agent
Date
(Please circle one.}
Alt permits are non-transferable and will expire if work authorized by.such permit is not begun
within 180 days of is:yuanee, or if work is suspended or abandoned for a period of 1 Bt) days
105 Yelm Auenue Weat (3S0) 458-3835
PO Box 479 (360) 458-3141 PAX
Yelm, WA 98597 www.ci.yeim.wa.us