09-0189 Permit Pkg 091509City o f Yelm
Community Development Department
Residential Certi f icate o f Occupancy
Building Address 16650 GREENLEAF AVE. 86
Owner Name YELM PROPERTY
DEVELOPMENT
Owner Address P 0 BOX 2950
YELM WA 98597
Building Permit Number 20090189 Plan Number
Remarks: SFR LOT 86 PLAN 1621
Areas Inspected ALL CODE REQUIRED
Special Conditions
Building Official: G. CARLSON Date: 1-6-2010
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
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: YELM PROPERTY DEV
Address: 16422 MIDDLE RD SE
YELM WA 98597
Property Information:
Site Address: 16650 GREENLEAF AVE.
Assessor Parcel No.: 84070008600 Subdivision:
Contractor Information:
Name: YELM PROPERTY DEV
Address:
16422 MIDDLE RD SE
YELM WA 98597
Contractor License No.:
Project Information:
Project: NEW RESIDENTIAL BUILDING
Description of Work:
Permit No.: 20090189
Issue Date: 9115/2009
(Work must be started within 180 days)
Phone: 360-458-0544
Owner: TYPE CURRENT OWNER
NAME
WILLOW GLENN III Lot: 86
Phone:
Expires: 0/00/0000
Sq. Ft. per floor: First 1015 Heat Type (Electric, Gas, Other): GAS
Second 608
Third
Garage 362
Basement
Fees:
Item Contractor
NEW RESIDENTIAL BUILDING YELM PROPERTY DEV
MECHANICAL YELM PROPERTY DEV
PLUMBING YELM PROPERTY DEV
TOTAL FEES:
Applicant's Affidavit:
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 regulations including those governing zoning and land subdivision, and in addition, all covenants,
easements and restrictions of record. If applying as a contractor, I further certify that I am currently
registered in the State of Washingtgn.
Firm
Fees
$11,956.83
$ 78.25
$ 104.00
$ 12,139.08
# Sets of Prints:
Final Inspection:
Date: - ~' ~-a 1 ~'
By:
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YELM COPOMBOXr476C~LS
YELM WA 98597
Clerk: Croy
Terminal: X06166
Receipt:
Manual Receipt:
NBROCKTGN
NBROCKTON
BROCKTON TON LC UCTIGN LLC, YELM PROPERT
DEVELOPMEN
9J15/2009 2:41 PM
Price
G1t~__! ---- - -------______-
2780.00
1 CPFREV 2900
MITIGATION
Willow Glenn III - l.ot 86
Subtotal: 2780',00
Tax: 2780,00
Total:
Check 2780.00
6315
Change Due: 0.00
THA1~( YOU
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
ProjectAddress: IL-,~,- 5U ~r«!~'4~ ~^'~ Parcel #: ~'~Gix ! it 1 ~ ~ ~y0-7 ouc~~b Gp
Subdivision: ~N if~0e~ U~P.'~e~1 3 Lot #: SG Zoning; ~~
New Construction ^ Re-Model / Re-Roof /Addition ^ Home Occupation Sign
^ Plumbing ^ Mechanical ^ Mobile /Manufactured Home Placement ^ Other
Project Description/Scope
Building Area (sq. ft) 151 Floor /~l~ 2nd Floor G~G~~ Garage 3 ~ ~ Deck
Basement Carport Patio
# Bedrooms. # Bathrooms~~'" Heatin :GAS/OTHE r ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? c~ If yes, a
completed environmental checklist must accompany permit application.
MECHANICAL CONTRACTOR Ccnl~~ iE-!~L TELEPHONE ~5~--~19S6
ADDRESS ~~2f L.4c t ''' EMAIL
CITY L-7f't~ STAT 1~_ZIP SO FAX
CONTRALTO '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.
Applica is Signature Date
Owner /Contractor /Owner's Agent /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 wu!rc.ci.yelnt.u~a.us
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AP ROVED
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