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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 City: Lakewood
Permit No: BLD-05-0500-YL
Issue Date: 03/22/2006
(Work must be started within 180 days)
Receipt No: 41197
Property Information:
Site Address: 14859 89th Ave. SE
Assessor Parcel No. 37540000800 Subdivision: Buckhorn Estates
Contractor Information:
Name: Evergreen State Builders Contact: Medina, Ed
Address: P.O. Box 197 City: Lakewood
Contractor License No: EVERGSB980PB Expires: 10/02/06275
Project Infaation:
Project: Buckhorn Estates
Description of Work: 2229/3 SFR, Lot 8
Sq. Ft. perfloor: (1st) 1038 (2nd) 1191 (3rd) 0
Heat Type (Electric, Gas, Other): GAS
Fees::
Garage 528
Phone: 253.475.8622
State: WA Zip 98499
Lot: 8
Phone: 25375-8822
State: WA Zip: 98499
Business License:
Basement 0
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
---------------------------
Building Permit 100-500k -----------
1,625.43 -----------
993.75 -----------
631.68 -----------
5.6000 -----------
112.8000 -------------
$1,000
Building Plan Review 686.74 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
Sewer ERU (LID) 2,847.00 0.00 2,769.00 2,769.0000 1.0000 ERU
State Building Fee 4.50 4.50 0.00 0.0000 0.0000
Fire District Impact Fee 595.51 0.00 595.51 0.2160 2,757.0000 square foot
TOTAL FEES: $8,747.93
Applicant's Affadavit:
4fFtC1AL 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 tnspection:
Date: / ~
Signature ~~i~~ Date ~~` z Z--~.~
Firm ~ ~ By.
I ~t ~
rW v i v -
E~17.GREEN S'1"ATE BUILDERS
BUCKHORN ESTATES
14859 89th AVENUE SOUTHEAST
7HUI~STON COUNTY, WA
PARCEL N0, 3754ao0800
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~2005 CASCADE RESIDEMTIAL DESIGN, INC. SG~~~ ~ ~ ~~~
TM19 ORA'NIN. 19 BA:ED ON CLICNY-v NDVp1CD NIPORMATION AEPRESEMED TO Df AGC VMATL
AND RLUAiI[~ YIY Dly'E(feO.WCIE3 RCTWEEN THIS DRAWING AMD YNr kCTUaI SIYE CDHDIT10N5
ARE THE 5C.E RESPOHSIBI~ITII 01 TNY pLiLNT.
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o~~f T"f P~ CITY OF ~`
YELM
P.O. Box 479
Yelm, WA 98597
360-458-8403
RECEIPT No.4119~7
RECEIV~Q*"EIGHT THOUSAND SEVEN HUNDRED FORTY SEVEN DOLLARS & 93 CENTS
RECEIVED FROM
EVERGREEN STATE DERS
P.0. HO% 3 3
LAKEWOOD A 98499
BLD-05 500-YL
LOT UCKHORN EST S
DATE REC. NO.
03/22/06 41197
BUDGETARY
AMOUNT
8.747.93 CHECK
~ ~ 5g~-
REF. NO.
PENDING
JANINE
1625.43.PLAN686.74.MECH78.25.PLUlvi118.SEWINSP145..WTERU1500..WTERU1500.
WTHET300..WTDEP40..SEWDEP50..TRAFF757.50.SEWERULID2847..STFEE4.50.FIRE595.51
s~'~f T~ ~ CITY OF
YELM
P.O. Box 479
Yelm, WA 98597
360-458-8403
RECEIPT No. 4119 8
RECEIVF~,*EIGHT THOUSAND FIVE HUNDRED SI%TY THREE DOLLARS & 52 CENTS
RECEIVED FROM DATE REC. NO. AMOUNT
EVERGREEN STATB BUILDERS 03/22/06 41198 8.563.52 CHECK
P.0. BOB 39753
LAKEWOOD WA 98499 BUDGETARY
HLD-05-0501-YL
LOT 9 BUCKHORN ESTATES
~ 158 ~-
REF. NO.
PENDING
JANINE ~
PERH 1562.71.PLAN660.24.MECH78.25.PLUH125..SEWINSP145..WTERU1500..WTNET300.WTD
EP40..TRAFF757.50.SEWDEP50..SEWERU2769..STATFEE4.50.FIRE571.32
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..___RESIDENT'IAL_,pU1LDING PERMIT APpI.ICA_T11G?N FORM
.~~ ~~,~,~ ,sue , _ '~9-" ~
Prvirdct Aadress:,~~ .. , ~ ~ . .
~h~'rr ~Ss Lot #_ ~ /.~ ~
Sub/dlvision:,~ ~_ Zpning; { ' G~~`%~~
LYNaw Construditm u Re-Model / Re`Roof / AOdition U Home Occupation Sign
U Plumbing u Mer~anical U Mobile !Manufactured Home Placement U Other
Project DescriptiorJScope of Work: JPiY'.Q l~' '-~f-C~i'u~~ ,' ~.Sr.~„~-~~~
Project Value: ~~~~ ~
~8uilding Area (sq, fl) 1" Fkwr/~T8 2id Ftgpr//~~ Gar~3ge _5~5~d pec{c_~
( r _~ 9asement Carport Patio_~Z~..'
# 6edravms,~ # Bathrooms~s Hea~ting~THER or ELECTRIC (Circle One)
Are there any erwironrnentally sensitive areas located o~ the parcel? 1f yes, a
completed environmental checklist must accompany permit application.
BUILDING OtNNER NAME: ~ ~ ,tr~-
ADDRESS - - EMAIL ~~ .~~
CITY STATE_G~' Z1P_ ~9 TELEPHONEf~.s3~ yS -~ !v~
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ARCHITECT/ENGtNEER S<.'~P s ICENSE #
ADDRESS /~ ,.Sty • EMAIL
CITYT~~~-CJl'!?~~STA'T~ GL.N SIP O TELEPI~iONE: CZ_ ~ - ~
GENERAt.GOI~RACTOR •S~c.Q~r<~ds..c•fc.~ TELEPHONE
ADDRESS _ EMAIL
CITY STATE ZIP FAX
GONTfiACTOR'S LICENSE # ~ ~~ EXP DATE o? CITY LICENSE #
PLUMBING CONTRA~"TOR mac}? lk.Pl~ LEPHONE ~"z.5=5 .~j7- ~a
ADDRESS i k/~ • H EMAIL
CITY %~fC~'a?~. _STATE ./g•~ ZIPS' ,FAX C'SS3~ . ~ >(G
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANIC CONTRACTOR : ~ TELEPHONE CZS~~~_ . ~' C-'
ADDRESS 5~7 ~ ~ ~. - EMAIL
CITY p STATE - ZIP •3'' FAX
~ CpNT CTOR' LICENSE # EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools. R applicable.
1 hereby t~rtl(y that 1M above Infore7atlan k camct snd that the cwratnuctlon on, and dw occupancy and >ti• ua• of the
above d•scrlliad property rr1Y be to scco-dence with the laws, rules ~d reyuladons of the Stste df WahMgton arM the
,~~ ~~~_ ~3 -~~ ~od
Applicant's SiBnaturrs Dabs
CJwner 1 Contractor ! Owher's Agent !Contractor`s Agent (Please circle one.)
Alt permits are twn•~transferable and trill expire if work authorized by such pvrmil is not begin
within 160 days of issuance, or if wvrit is suspended or abandoned for a period of 1 BO days
!U5 Yrim Auenar West fasaj use-sera
1~0 Bos !79 (Si0) IS6J111 FAX
Yelm, WA 983!7 eumw.aiyeJw,wd.w
~9 3J~d ~13Q~If1S 1S PJ33219~13r13 L~Z9SLv~SZ 9b=5i 999~/LZ/~9
FROM :YELM SEWER DEPT.
o~oF :H~ p
4 ~~+
YEx.M
YVI.M~INOTON
FAX N0. :360-458-f3166 Sep. 26 2006 84.43PM P1
FA.X TRANSMISSION
CITY OF YEI.M
P.O. BOX 479 - 931 NP ROAD NE
YELM, WA ~-8597
360-4S8-8411
~~ AX 360-45$-f.{ 166
TO : G ~ ~c r~E~
E.A.X##:
From: ~~~`r'
Subject: 1-~-s uSE ~ INS ~5
~ucK }4oR~ ~ ~~ i ,
Cr(~NIMENTS: ~ oT ~-~ ~ ~,~,~ 9
DATE: 9-~ ~~o~
PAGES: ~ ,including this
Cover sheet
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*~ 11'you do not receive all epics or any copy i~ not legible, please call (3fi0) 4SR-84l 1
as soon as possible.
CITY OF YELM INSPECTION LOG
PROJECT ~ ~9/~ ~d ~~
PERtiIIT N-liMBER~~- Q.~~6
ADDRESS ~ ~f ~5 ~ ~' 1 ~ ~~S ~
SET BACKS Date: =~~~` ~'
Front ZO
Rear may- 1
Side/F'lankina Cp
Side ~'~
WAIL
^ 6"
g,:
^ other
FOOTING REBAR ~- Date ~ 2. .~, WALL REBAR 4,~- Date: f
Comments
COMBINED FRAME/ EXTERIOR SI3EAR W~~S~~,~ION
Hold downs ^ ~6 She ~rl~~fai~lin jj~~°° ~ ~G ~(~
°'' Frame C~G'fL, (,2b Gas/Propane o,~ . ~ c`~?c-
Plumbin~ ~' p ~ Mechanical ~ o~ "~
Comments
I1~TSULATION Gas D Electric 0 other
(~oam and Seal ^ Vapor barrier ^ PVA
Comments ~b~~~~r ~~
S>E-IEET ROCI~lSHEAR FALL NAIL
Comments
OTHER
~,r .\ T
~yw•er Final
_ Address
Comments
;Electrical ~ Civil Final ~ Landscape Final
~ulation _ Sitz Draina,e ,,Sidewalk
FOOTLE G
^ 12"
16"
^ other
^ required vents,
Comments l~ ~/~/7/~ ~ .