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T City of Yelm
O7
Applicant:.
Name: Quadrant Homes
Address: P.O. Box 130 City: Bellevue
Community Development Department
Building Division
Phone: (360) 458-84
Fax: (360) 458-3144
w~sN~waTON
Property Information:
Site Address: ~ ~ ~ 3~ ~ ~k
Assessor Parcel No. Subdivision: Tahoma Terra
Contactor Information:
Name: Quadrant Homes Contact:
Address: P.O. Box 130 City: Bellevue
Contractor License No: QUADRC*221OF Expires: 09110107253
Project Irr~ormatiQn
Project: Tahoma Terra, Division I
Description of Work: 2141 B12L, Demo lot 34
Phone: 425-452-0332
State: WA Zip 98009
Lot: 34
Phone: 425-646-8363
State: WA Zip: 98009
Business License:
Sq. Ft. per floor: (1st) 869 (2nd) 1309 (3rd) 0 Garage 422 Basement 0
Heat Type (Electric, Gas, Other): GAS
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Building Permit 100-500k 1,545.35 993.75 551.60 5.6000 98.5000 $1,000
Building Plan Review 1,004.47 0.00 0.00 0.0000 0.0000
Mechanical Pem~it 78.25 0.00 0.00 0.0000 0.0000
Plumbing Permit 118.00 20.00 98.00 7.0000 14.0000 Fixture
Sewer ERU (LID) 2,769.00 0.00 2,769.00 2,769.0000 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
TOTAL FEES: X8,312.07
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 inconformity 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 Date j
Firm
Permit -vo: BLD-05-0331-YL
Issue Date: 10/10/2005
(Work must be started within 180 days)
Receipt No: 38517
C}I~I.Y
Sets of Pnnts:~ '~
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Final Inspection; ''
Date:
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T ABDVE SKETCH S RGVIDED FQ YOUR INFGR~dATICN ONLY. IT IS NCT INTENDED TQ SHG~Y .~~ t~`ATTERS
RELATED TD THE PROPERTY, INCLUDING BUT NGT LIMITED T0, AREA, DI~iENSIGNS, EASEMENTS, ENCRCIACHI~ENTS
GR BOUNDARY LGCATiQNS NGR IS IT INTENDED TG BE USED FCR LEGAL DESCRIPTIGN ~3R SURVEY PURP~3SES.
E ENCOURAGE YGUR REFERENCE TC~ ACTUAL DOCUMENTS, TITLE SEARCHES A.ND COMMITMENTS t3R SURVEYS
RELATED TD THE PROPERTY FQR FURTHER INFCR~iATIC~N.
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O
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: Terra View ST SE, Yelm (Model) Parcel #:
Subdivision: Tahoma Meadow Div 1 Lot #: 34
Zoning; R3
d New Construction D Re-Model / Re-Roof /Addition ~ Home Occupation Sign
d Plumbing ~ Mechanical D Mobile 1 Manufactured Home Placement D Other
Project DescriptionlScope of Work: SFR (Basic Plan Series LS 2100-30, Plan # 2141 B)
Project Value:
Building Area (sq. ft) 1St Floor 869 2~d Floor 1,309 Garage 628 Deck 150 orch
Basement 0 Carport 0 Patio 150 (opt.)
# Bedrooms 4 # Bathrooms 3.5 Heating: AS OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? No If yes, a
completed environmental checklist must accompany permit application.
MECHANICAL CONTRACTOR BoB'S NEW CONSTRUCTION, ~N~. TELEPHONE 425-889-9345
ADDRESS 13633 NE 126T" Place, Suite 350 EMAIL
CITY Kirkland STATE WA ZIP 98034 FAX 425-889-0630
CONTRACTOR'S LICENSE # BOBSNNC9776B EXP DATEo9io2io5CITYLlCENSE #
Copy of mitigation agreement with Yelm Community Schools, if 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 property will be in accordance with the laws, rules and regulations of the State of Washington and the
City of Yelm.
r
on behalf of Quadrant Homes
912612005
Applicant' Signature Date
Owner 1 Contractor 1 Owner's A ent 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
PO Box 479 (360) 458-3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us