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20050422 W Q ~g a Q U ~ ~ 0 ~ v W Z ~_ U_ M~ ~` W r (~ J J } Q LL Z O . W ~~ ~ V W a~ E Z c co a ai f0 N 7 fn V1 Z ~ y N .. ~ ° io d -~ N N ~ U _ ~ U Q ~v a N ° U O rn ?Q rn ~ rn N N ~ (0 to • V C C - ~ ~ N m ~ ~ m ~ Q ~ m c N ~ a~ c0 N L d U y 'v c U °°o _UN ~ a~ - ._ ~ o ,, ~U ° N rn~ ~ .c ~ ~-o> ~j U CC~w O ~ ~ .~ ~ C a`~~U ~o~ ~ ~N w •C p L fn fd 3~ c ° ° m U L f~ C +r N •Q ~ o' E ~ N o w, ° U Q ... C ~ ~ .N <° V N N ~ c0 O j N > _N ~ t ~ H r lf') WA ER INSPEUCTIO~, CTIpN DATE: 8 a.~- ~ ~? DEVELOP~NT: ~~ CS t c.or u = mob. r.or # o~- LOT# ~~ 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 Properly Information: Site Address: 14912 89th Ave. SE Assessor Parcel No. 37540001500 Contractor Information; Name: Evergreen State Builders Address: P.O. Box 39753 Contractor License No: EVERGS6980P6 Project Information: Project: Buckhorn Estates Description of Work: 152812 SFR, Lot 15 Sq. Ft. per floor: (1st) 788 (2nd) 740 Heat Type (Electric, Gas, Other): GAS Fees: City: Lakewood Permit Ivo: BLD-05-0422-YL Issue Date: 12/20/2005 (Work must be started within 180 days) Receipt No: 39514 Phone: 253-475-6622 State: WA Zip 98499 Subdivision: Buckhorn Estates Contact: McCuilem, Tom City: Lakewood Expires: 10/02/06275 Lot: 15 Phone: 253-475-6622 State: WA Zip: 98499 Business License: 1042.0 (3rd) 0 Garage 375 Basement 0 Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc --------------------------- Building Permit 100-500k ----------- 1,223.35 ----------- 993.75 ----------- 229.60 ----------- 5.6000 ----------- 41.0000 ------------- $1,000 Building Plan Review 516.86 0.00 0.00 0.0000 0.0000 Mechanical Permit 78.25 0.00 0.00 0.0000 0.0000 Plumbing Permit 125.00 20.00 105.00 7.0000 15.0000 Fixture Sewer ERU 5,417.00 0.00 5,417.00 5,417.0000 1.0000 ERU 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 Traffic Facilities Charge 757.50 0.00 757.50 750.0000 1.0100 Peak PM Trip Sewer Deposit 50.00 50.00 0.00 0.0000 0.0000 State Building Fee 4.50 4.50 0.00 0.0000 0.0000 Fire District Impact Fee 411.05 0.00 411.05 0.2160 1,903.0000 square foot TOTAL FEES: $10,568.51 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 th/e State of Washington. Final Inspection: Si nature Date g ,/G i~~~~/r~ ~Z ~Z~ ~s Date: Firm ,`"f~ By. a~ F T"FP9~ CITY OF a ~, YELM YePmO, WA 98597 RECEIRT No. 3951.4 L 360-458-8403 RECEIVED \ ****TEN THOUSAND FIVE HUNDRED SI% EIGHT DOLLARS & 51 CENTS `; RECEIVED FROM DATE REC. NO. AMOUNT REFS NO. EVERGREEN STATE BUILDERS PO BO% 39753 LAKEWOOD. WA 98499 BLD-05-0422-YL SITE: 14912 89TH AVE SE 12/20/05 39514 BUDGETARY 10,568.51 CHECK PENDING BLDPRMT1223.35, PLNREV516.86, MECHPRMT78.25, PLMB125, S/ERU5417, S/INS145 W/ERU1500, W/MTR300, W/DEP40, TRAFF757.50, S/DEP50. STFEE4.50, FIREDST411.05 / ~Of THpP~ a ~ CYELMF Ye m~WAX98 97 RECEIPT No. 3 9 515 Y L 360-458-8403 RECEIVED ****ELEVEN THOUSAND ONE HUNDRED SIBTY THREE DOLLARS & 59 CENTS RECEIVED FROM DATE REC. NO. AMOUNT REF. NO. EVERGREEN STATE BUILDERS 12/20/05 39515 PO BO% 39753 LAKEWOOD, WA 98499 BUDGETARY BLD-05-0424-YL SITE: 14906 89TH AVE SE 11,163.59 CHECK PENDINGI BLDPRMT1553.31, PLNREV647.82, MECHPRMT78.75, PLMB132, S/INSP145, W/ERU1500 W/MTR300, W/DEP40, TRAFF757.50, S/DEP50. STFEE4.50, S/ERU5417, FIRE 557.71 YELM COMMUNITY SCHOOLS v 2 5 5 9 7 LOCAL RECEIPT DATE ~ -- 1 g--- Received from ~JL~(.(~( Lam,. ~,~,~ v ? FOR ~'I.c-~~ ~~ ~~ ~°' ~ 1 Z i ~ 3 ~ ~ ~` ~~_ v "' ~ -" DOLLARS ACCOUNT CODE AMOUNT CASH CHECK JCi ~'p 7 V Ff~ $_ ~o~~y• YELM COMMGNITY tiCHOOIS Bv- ,~~ City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360)458-3144 Permit Fees Schedule Permit No: BLD-05-0422-YL Applicant: Name: Evergreen State Builders Phone: 253-475-8622 Address: P.O. Box 39753 City: Lakewood State: WA Zip 98499 Project Information: Project: Buckhorn Estates Description of Work: 1528/2 SFR, Lot 15 Site Address: 14912 89th Ave. SE Assessor Parcel No. 37540001500 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 ----------- 1,223.35 ----------- 993.75 ----------- 229.60 ---------- 5.6000 ----------- 41.0000 ------------- $1,000 Building Plan Review 100 001-345-83-00 516.86 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 032 001-322-10-00 125.00 20.00 105.00 7.0000 15.0000 Fixture Sewer ERU 802 412-343-50-01 5,417.00 0.00 5,417.00 5,417.0000 1.0000 ERU 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 Traffic Facilities Charge 420 120-345-85-00 757.50 0.00 757.50 750.0000 1.0100 Peak PM Trip Sewer Deposit 742 402-389-01-00 50.00 50.00 0.00 0.0000 0.0000 State Building Fee 160 001-386-00-00 4.50 4.50 0.00 0.0000 0.0000 Fire District Impact Fee 105 001-345-85-00 411.05 0.00 411.05 0.2160 1 ,903.0000 square foot TOTAL FEES: $10,568.51 12f 13f 2005 17:52 2532843183 CAS RES NWAF TDM PAGE 07 1 /'1't' 1 t 1-t/ I 1:J SUCffi34RN BSTA'PES ~ ~9 ],z 89th ,A,VENUL 8©T,~,AST ~ ~ ' ~. T~U~'!`ON CDUAiTSf,'i~A P1i&CEL N0.3T840001800 i DEC 1 ~ 2005 R~~~~~~ DEC 1 ;; 2005 ~ 1 57.05' ..,,,~ w ~~----~-.. v ~ ,- ti ~ ~- 29' -1.71 " ~~--- 3 2' 7'`°a,. \ 25' 6 OYERWANG Y ~~, ~,I ~ ~~ m ~ 1-~ ` ~ ~l i~ Q 1 ~ ~. CENTER OF ~~~ c ~ ~ +{'' CUL DE SAC ~ ~~ ~ iV ~ ~ 1,~~ ~ ~r l ~ ~~ ~ m I ._. ~ \t ~ ~ ~~` 1 Q' UT1L. ESMT. ' ~ •9~,, ~...... 35.72' ~ ~,.'~ r f ,. ~ ~ ~. ~~ ~ 89#h AVE. S~ / _ ~. CJ ~ ~ ~ ~~., r4N NOR7!-1 ~} 2005 CASCADE RESIpENTIAI~ pESIGN, INC. ~JG,4LE ~, = ~~, TNIF DRAWING IS BASED ON Cl1ENY-PROVIDED INFORYIAnffN RgvRE3ENiED Th BE ACCIMATE AND RELIA6I.E~ ANY GISCREPANCIE5 DETWF.i,H THIS ORnWIMR ANh THE A4TUAl ^u1TE CfrNdT10N5 ARE THE SOLE RESPONSIAhtTr oP THE aaEUT. I~u~ ~rN RY11I Flvarctr ~ i e.~•a~ CITY OE YELM ~51DfNTIAL BUILDING PERMIT APPLIC,' ~`"~N FORM Project Address:./~ji L ~°s ~ ~v~ S~ Parcel #: /SZv~/Z Subdivision:`741"0'1 S Lot #:_ _/,~ Zoning; ~Cc,,~ ~~ ~~~~rz~ LYNew Construction u Re-Model / Re-Roof J Addition u Home Occupation Sign U Plumbing U Nlechanicai U Mobile /Manufactured Home Placem~engt--~ u Other Project DescriptioNScope of Work: ~,1~ I~ ~~11'72c..~~/ ,~Q~~~~.,r:..e..e Project Value: ~ ZZ~I, yv~0 Building Area {sq. ft} i°` Floor~~ 2'~ Floor Garage .~~.5 Decker Basement Carport ..Patio Z~•6 # Bedrooms # Bathrooms 2•S Heat' g: 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: Da~7r ~r...r~_D ~,' ~ S ~ ly ADDRESS - EMAIL ~° f~ ls_ Q~S~, ~" CITY Lcc. ~ct~d -STATEI~i' ZIP q'~ TELEPHONECZ.s3~'~7S ~o GoZ ~. ARCHITECTJ~~NGINEER SC''lr' ICENSE # '~ ADDRESS /('~ ~ ~ EMAIL CITY"7a~ .STATE <~ZIP ~ ~ TELEPHONE.CZS~>~- ~/~~j GENERAL CONTRACTOR S'CG~PGt C7G~c.G~1~ TELEPHONE ADDRESS EMAIL CITY .STATE ZIP FAX CONTRACTOR'S LICENSE # C. //~ s£'!~ EXP DATE c~7 CITY LICENSE # PLUMBING CONTRACTOR `S~r~I I1~C?4 ELEPHONE_CzS~~ -~~7- %®C5 ADDRESS. /`~/~ ~` EMAIL CITY %lCG'C~2? ~. .STATE ZIP~~/~ ~ FAX. ~ g'3~ „3~~ -~f ~p(c' CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # MECHANICAL CONTRACTOR ~'~'` '~ TELEPHONE CZ.S~) ' ~'- ~? G1 ADDRESS ~ ~~t ~-~ EMAIL CITY P .STATE ZIP 3~ FAX CONT CTOR' LICIE.NSE # EXP DATE CITY LICENSE # Copy of mitigation agreement with Yelm Community Schools, if applicable. i hereby certify that the above information is correct and that the constntction on, and the occupancy and the use of the above described property will be in accordance with the laws, rules and regulatlons of the State of Washington and the City of Ye1m. . Applicant's 5ignaltir~s Owner J Contractor 1 Owner's Agent 1 Contractor's Agent _ ~~ ~y m S Date {Please circle one.} Ali 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 113Q days 105 Yelm Auenue Weat (360) 458-3835 PO Box 479 (3B0) 458-3144 FAR Yelm, WA 98597 tvrum.ei.yelm.wo.ua