20050166 Permit File 061505CITY OF YELM -BUILDING DEPARTMENT
RESIDENTIAL CERTIFICATE OF OCCUPANCY
Building Address
Owner Name
Owner Address
Building Permit Number BLD-05-0166-YL Plan Number Plan 2502 S!2 Lot 93
Areas
Special
Building Official: G. Carlson Date: December 14 2005
This structure is in compliance with the International Residential Code (Chapter
51-51 WAC) as adopted by the Washington State Building Code Council pursuant
to Chapters 19.27 and 70.92 RCW, effective July 1, 2004
~OF THEP City of Yelm Permit No: BLD-05-0166-YL
a ~ Community Developmen t Department Issue Date: 06/15/2005
4 ~i
Building Division t1Nork must be started within 180 da s
y >
Phone: (360) 458-8407 Recei pt No: 37014
EL Fax: (360) 458-3144
Applicant:
Name: Evergreen State Builders
Phone: 253-475-6622
Address: P.O. Box 39753 City: Lakewood State: WA Zip 98499
Property Information:
Site Address: 15788 Yelm Terra Way SE
Assessor Parcel No. 85840009300 Subdivision: Yelm Ter ra Lot: 93
Contractor Information:
Name: Evergreen State Builders Contact: McCullem, Tom Phone: 253-475-6622
Address: P.O. Box 39753 City: Lakewood State: WA Zip: 98499
Contractor License No: EVERGSB980PB Expires: 10102/06275 Business License: 1042.0
Project Information:
Project: Yelm Terra
Description of Work: Plan 2502 S/2, Lot 93
Sq. Ft. perfloor: (1st) 1034 (2nd) 1467 (3rd) 461 Garage 0 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 1,408.90 993.75 415.15 5.6000 74.1340 $1,000
Building Plan Review 595.26 0.00 0.00 0.0000 0.0000
Mechanical Permit 78.75 0.00 0.00 0.0000 0.0000
Plumbing Permit 132.00 20.00 112.00 7.0000 16.0000 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
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
Sewer ERU 5,417.00 0.00 5,417.00 5,417.0000 1.0000 ERU
TOTAL FEES: $10,428.91
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 r ulations including those governing zoning and land subdivision, and in addition, all covenants,
easeme nd restrictions of record. If applying as a contractor, I futher certify that I am currently
registered i .~ State of Washington.
Firm
Date
Sets of Prints:
inallnspection:
Date: ~ - ~~ - ~! -~
By: ~~
/"~
Yelm School District
ATTN. SUSAN CROY
PO BOX 476
YELM, 4JA 98597
360-458-1900
Sold to: 16755
EVERGREEN STATE BUILDERS LLC
56622
BUILDERS LLC EVERGREEN STATE
5516 75TH ST W #1
LAKE!~JOOD, WA 98499
# 6073 09 06/15/05
Reg #1 Salesperson SUSAN
Item # 2900/MITIGATION
MITIGATION/CAPITAL PROJECTS
00
844
6
.
,
1 ~~ 6,844.00
CK #09865 FOR YELM TERRA LOTS 37,3 ,93~ 9
SubTotal 6,844.00
Total Due 6,844.00
Check 6,844.00
Thank you.
PLEASE KEEP THIS RECEIPT!!!
e5/b:~/1bb5 15:14 2534741477 CASCADE RES DESIGN PAGE 04
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EVERGREEN STA'T'E BUILDERS
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~ELMj WA
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SCALE I' 30'
INiOAMATIDN R~PRESENTFD TD eE ACCURATE
'HIS DRAw~~vG 4n0 rNE ACruA~ SITE CDN~rnONS
1~'roject Address:,ls~~~ .~~~"'__~~;° ~.'r' ~G~,par~i" ,i~:~-.-~ ~' Z 'S
Subdivisian:~c°~d~e~ ~Je~~~. tat #:....~,.~...._, ?.'.ariirrg; ~-l~•,.~,.~~' -~l'l~i~„' ~~
~~NoW Cart~truc1ian U Re-Model ! r~~-Ftt~at' 1 Adt~itian l~ tir~me Orxupatirm Sign
u plurrtbing u Nlechania~l t~ Mabile / Me~ni:f-~ctt~d Home F'lacemtlnt u Other
-~-~~~i ~ l 0~'N
Project Descri tion/~cope t?f~~W//rar'k ~~lJ~..(f .~..._~y ~((~~•- l ~-
PrvjeCt VeIU ~ 7~ _._ ..._~__..~_
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wilding Arne (tsq. R) 4~' ~laor~,~ Z Fle~ot/yG ~ (yers-ge ~ baclc~/Z
E~esement __-___Carport Patia_`_
# Badranms,~ # Bathroomt~ Hc~ati : GA ' 1'HER ar ~t_ECTRIC (Circle Coe)
Are there r~ny envirnnmerttally senyit~ve arses located ran the p~trcel'r ~__,!_ 11 yes, a
completed ®nvironm~-r-tal checkiiet rrruet acromprany permit application.
Capy of miti<pation agreement with Yeirn Cdrn-riunity Schr~nis, if appiit:abie.
herwby certNy thel tlw attcre~ Inrormddion to com+ct and trtet the coraetiVuctitm ors, and the e~+ccupen~y end fhe uaa ~'tha
ubovx described prnperty will be In ac~ordunce with the taws, e~utss and r~edulntla~ne a4 the Mats of Waohlnyton and the
City of Yefm.
Applicant's 8ignatur~ __. _.-..-•-----., ~~ pate
Clwner 1 Contras;tor~gwner's Age Contractor's Agent {pleas clrclre nne~)
All permits are non-treinaferable and vvil9 expire if work auttxas~ized by such permit i6 trot ttegun
within 180 days nfi Its+suasyce, or if virdrk is suspended or abandoned far a period of 180 ctgye
l0.5 Yefm Auenue UVest y ~----------- Y__.-.--------- -.__.__ (ssu) ae~-~~~s~ __
P! ~ 479 (1tB0) 48tL.Y144 F.4~K
Yw[na WVA~ 9NS87 iawm.ci _ve1N~.+ua.ue
CITY OF YELM INSPECTION LOG
PROJECT ~b^
PERMIT 1\UA9BER /~~ ~--G j ~~ (9(~ - ~~
SET QACkS Date: FOOTiI~G ~~'.qLL
`1 Front 7~ C ] 2'' ~C 6"
~ "~ Rear C ] 6'' C g"
~~~ ~.,~ Side Flan}:ing ~' C other 0 other
~\ Side h C required ~~ents
FOOTIIC REB.aR °j Date: (~I~ \~'ALL REB.~R /~ate:__~p~i
C011I31~ED FR.a'~1E/ E\TERIOR SHE.aR «'.aLL I~SPECTIO\'
Hold do~~ns J Shear:~'ailine
Frame C ~ ~ Gas'Propane~ ~' t Gh
Plumbing C 'Mechanical C
I\St'L.~T10;~' ~' Gas '~ Electric '~ Other
q' Foam and Seal ^ Vapor barrier = ~ p~'..~
Comments !~~~ ~l1~ln~ 'mot ~,/l.. ,.~~~' .~. ,Y .. _. ;~ ~ .
SHEET ROC}USHE.aR «'.aLL \.~IL
OTHER
F11.aL
0 Se~~~er Final n Electrical J Cis it Final `~ Landscape Final n C of 0
C ,address C Insulation C Site Drainage '~ Side~~alk
'~': ^t : Y~_M SEWER DEPT
~ i
I~A~vI
FAX N0. :360-458-f3166 Dec. 15 2005 11:00AM P1
FAX TR,ANSMISSIaN
CITY OF YELM
P.O. B()X 479 - 931 ~~1P ROAD NE
Y"ELM, WA ~~ 597
360-458-8411
F,AX 360-458-8166
TU: ,C~- ~~ r j I~~n)
FAX#:
From: I~ /~ N ~ ~'
DATE: l~ ~ J ~~ ~~~r
PAGES ; 1 ,including this
Cover sheet
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COMMENTS: ~ ~ T ~ ~ I `~ 7 ,~ ~ ~ ~' C-~,,~-, ~ ~=~z~z,~1 ~A
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05-5130.00
** if ou do not receive all copies or any copy is nay legible, please call (364) 458-8411
Y
as soon as possible
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