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07-0388 Permit Pkg 102907,~ ~~ ,~ ~~ D~ ~.~~ o~~ v ~~ v ~ 3~ 0 ~~~ ~o ~a~ -~ ~. N .~ J ~ n m Q~~ ~~~ o?.~ ~~ ~ N~ ~ O ~ ~ ~ .+ ~~~ ~~~ ~, ~ o ~W= __. <~:~ ~s~ ~. ~~~ ~o ,~~. - m v N ~ - O ~ (7 ~ = O ~ ~ O. n ~ ~ C7 ~ ~ C ~ v CD ~ ~ W c n ~' c~ O v' cn D ~ ~ m ~ ~ N v' 5 n ~ o' a I m 3 v c a ~' cQ m z v z CD O W O ~ m ~ m n ~ ~ cn n ~ Q ~ ~ m i u ~ ~ m n ~ ~ m ~ ~ W ~ o ~ z ~ ~ ~ ~ ~ ° ~ ~ D ~ m ~ °° ~ ° ~ ~ v ~ ~ n ~ ~' ~. ~ I ~ ~ ~ ~ C _ ^ `I r D ~ m Z G7 O p r O D n ~ ~ ~ Z Z D Permit No: BLD-(~7-0388-YL Issue Date: 10/29/2007 ,'~~,~ (Work must be started within 78bFdays) Receipt No: 50978 Address: P.O. Box 98742 City: Lakewood Property Information: Site Address: 111 Rice St. SE Assessor Parcel No. 75300400900 Subdivision: Contractor Information: Name: Applicant Address: Contractor License No: Contact: City: Expires: Project Information: Project: Bart McCullough Description of Work: Complete duplex Sq. Ft. per floor: (1st) 864 (2nd) 0 Heat Type (Electric, Gas, Other): GAS (3rd) 0 Garage 316 Phone: 253-223-4403 State: WA Zip 98498 Lot: Phone: State: Zip: Business License: Basement 0 Fees: Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc Building Permit 50-100k 904.15 643.75 ------- 260.40 --------- 7.0000 --------- 37.2000 ----------- $1,000 Building Plan Review 382.00 0.00 0.00 0.0000 0.0000 Mechanical Permit 74.00 0.00 0.00 0.0000 0.0000 Plumbing Permit 69.00 20.00 49.00 7.0000 7.0000 Fixture State Building Fee 4.50 4.50 0.00 0.0000 0.0000 Fire District Impact Fee 254.88 0.00 254.88 0.2160 1,180.0000 square foot Water ERU 1,500.00 0.00 1,500.00 1,500.0000 1.0000 ERU Sewer ERU 5,725.00 0.00 5,725.00 5,725.0000 1.0000 ERU Sewer Inspection 145.00 0.00 145.00 145.0000 1.0000 ERU Traffic Facilities Charge 255.20 0.00 0.00 1,276.0000 0.0000 Peak PM Trip Water Meter (SFD) 300.00 300.00 0.00 0.0000 0.0000 TOTAL FEES: $9,613.73 Applicant's Affadavit: OFFICIAL'USE ONLY 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:.. Signature ~-- Date ~ ~ ec'~ O Date: Firm ----- ---- ------- - By: CITY OF YELM ..~. F ~ IDENTIAL BUILDING PERMIT APPLICA N FORM Project Address: ~ L{~- Parcel #: ~ ~ ~ o ~ "! Subdivision: Lot #: Zoning; 7 ? ~. ~-S~~~v~t-~.. j .~ C Ov~c ~ >)S( New Construction u Re-Model / Re-Roof /Addition u Home Occupation Sign u Plumbing u Mechanical u Mobnbile /Manufactured Home Placement u Other Project DescriptioNScope of Work: ~ ~ tX ~~ I '~ ~ ~ ~ ~~ `~- X Project ~~i ~ ~~ Building Area (sq. ft) 1~` Floor 2"d Floor Garage ,~~ Deck Basement Carport Patio # Bedrooms ~ # Bathrooms Heating: GAS/OTHER or LECTRI Circle One) Are there any environmentally sensitive areas located on the parcel? ~ d If yes, a completed environmental checklist must accompany permit application. ~~3~ OS~ ~~ BUILDING OWNER NAME: a r -{- ~'c. L.. / ca c~c' ~-. ADDRESS 1 d ~ /Z, r c~ EMAIL u.^--~ f ~!~ ~ eo.C c~s~ CITY ~-e Imo-. STATE_~ZIP dIJS9~ TELEPHONE 2S"~~L Z 3_V y`a3 ARCHITECT/ENGINEER ~r.~•-~~" ta~" o~/ LICENSE# ADDRESS ~° ~ l30 ><• Z9 ~ EMAIL CITY y{? I v-~ STATE V/ ZIP $S~ 7 TELEPHONE ~6 0 FS -- / 6~5~ GENERAL CONTRACTOR e- TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # PLUMBING CONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # MECHANICAL CONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # 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 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. Z ~ O G~ ~~ rt's Signature Date Contractor /Owner's Agent I 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 Aaenue Weat ~; ,~,, PO Bos 479 Yelm, WA 98597 ~~~ ~.>=.(360).58-3835 (360) 458-3144 FAX roww. ci.yelm.wa. ua r! d J W r "~ [~ H H x r r ,~ '. ~nxN~ Ht~r~n y r --, c~ C'] LT] J ~ co r ~v~r- f--~ y O , xc y G1 H~+cx ~~~ ~~ ~, m~ ~ y y o~ C d G~ y x -C N m N m m t,p ~~ t0 1-~ w J W C~ ~- r T z H z =, x 0 C z a to H DC x c z v x c~ d D y x m H y LTJ z m d C3 O Z r o r a~ J D W O ~ C ~ Z -~ z y i!~ C'] x n x F~-~ .:v ~p m ~ ,T, ~ Z O I ~~, i ~~ ~~~ \~ r'. ,~~ ~ ~'y1 ,f~,~r, t[ ~~~ J~ -, O ~ [~ ~~ ~X~~~ V.:~~ P (T v ~~ ~~ ~:~ rn n rn_ Z 0 v wOF THFP@`~` City of Yelm `~ Community Development Department d ~i Building Division Phone: (360) 458-8407 YEL Fax: (360) 458-3144 Applicant: Name: McCullough, Bart Address: P.O. Box 98742 Project Information: Project: Bart McCullough Description of Work: Complete duplex Site Address: 111 Rice St. SE Fees: Item ---- Acct Code ----------------------- Building Permit 50-100k -------------- 032 001-322-10-00 Building Plan Review 100 001-345-83-00 Mechanical Permit 032 001-322-10-00 Plumbing Permit 032 001-322-10-00 State Building Fee 160 001-386-00-00 Fire District Impact Fee 105 001-345-85-00 Water ERU 715 401-343-80-02 Sewer ERU 802 412-343-50-01 Sewer Inspection 805 412-343-80-00 Traffic Facilities Charge 420 120-345-85-00 Water Meter (SFD) 712 401-343-80-01 TOTAL FEES: Permit Fees Schedule Permit No: BLD-07-0388-YL Phone: 253-223-4403 City: Lakewood State: WA Zip 98498 Assessor Parcel No. 75300400900 Item Fee ----------- Base Amt ----------- Unit Fee Unit Rate No. Units Unit Desc 904.15 643.75 ----------- 260.40 ----------- 7.0000 ----------- 37.2000 ------------- $1,000 382.00 0.00 0.00 0.0000 0.0000 74.00 0.00 0.00 0.0000 0.0000 69.00 20.00 49.00 7.0000 7.0000 Fixture 4.50 4.50 0.00 0.0000 0.0000 254.88 0.00 254.88 0.2160 1 ,180.0000 square foot 1,500.00 0.00 1,500.00 1,500.0000 1.0000 ERU 5,725.00 0.00 5,725.00 5,725.0000 1.0000 ERU 145.00 0.00 145.00 145.0000 1.0000 ERU 255.20 0.00 0.00 1,276.0000 0.0000 Peak PM Trip 300.00 300.00 0.00 0.0000 0.0000 $9,613.73 ' ~~J ~E --~.. C .,~, ~ ~.~ `~_ k.. _._~. e FROM :YELM SEWER DEPT. FAX N0. :360-458-E3166 Apr. E4 ~EIeB ©1:2ElPM P1 RECEIVED APR 0 4 1008 ~~ H~ p~ ~`~ ~, ~~~ TR.AI~SIIIIISSIf~N ~~ C1TY QF YEL.M ~" P.O. BfJX 47'9 - 93 ~ NP 1ZOAD NE YELiVI, WA 98597 3b0-4S8-$411 ~~ ~ FAX ~3b0-458-$ I bb T'O: ~ ~.~ .,. r1 C.N F.A,X#: DATE: y- ~~.~ ~, ~-~- 1'AG1JS: f , inclr~ding this C®ver shcex From; ~'f3-~ 0 `j Sub,~ect: N a uS ~ ~ ~n~,4 ~- ~ ~S-°C' ~~~~ ~~ ** 11'you do not rc;ceive ali copies car an,y copy is nat legible, please calb 3~.t~) h58~8~~•t t as soon as possible.