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CITY OF YELM -BUILDING DEPARTMENT
RESIDENTIAL CERTIFICATE OF OCCUPANCY
Building Address
Owner Name
Owner Address
Building Permit Number BLD-09-0009-YL Plan Number Plan 948 B, Lot 121
Areas
Special
Building Official: G. Carlson Date: June 8, 2009
This structure is in compliance with the In#ernational 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: Tahoma Terra, LLC
Address: P.O. Box 627
Property Information:
Site Address: 14459 100th Ave, SE
Assessor Parcel No,
Permit No: BLD-09-0009-YL
Issue Date: 01/20/2009
(Wo rk must be started within 180 days)
Receipt No: 58091
Phone: 360-400-0740
City: Rainer State: Wa Zip 98576
Subdivision: Tahoma Terra, Division I, phase II Lot: 121
Contractor Information:
Name: Tahoma Terra, LLC Contact: Bloom, Doug Phone: 360-400-0740
Address: P.O. Box 627 City: Rai ner State: Wa Zip: 98576
Contractor License No: Expires: 09110/07253 Business License:
Project Information:
Project: Tahoma Terra, Division I, phase II
Description of Work: SFR Lot 121 Plan 948 B,
Sq. Ft. per Floor: (1st) 872 (2nd) 1236 (3rd) 0 Garage 381 Basem ent 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 1,011.92 993 75 18.17 5.6000 3.2440 $1,OOOY
Building Plan Review 427.54 0.00 0.00 0.0000 0.0000
Mechanical Permit 78.25 0.00 0.00 0.0000 0.0000
Plumbing Permit 111.00 20.00 91.00 7.0000 13.0000 Fixture
Sewer Inspection 145.00 0.00 145.00 145.0000 1.0000 ERU
Water Meter (SFD) 300.00 300.00 0.00 0.0000 0.0000
State Building Fee 4.50 4.50 0.00 0.0000 0.0000
Police Mitigation -Tahoma 310.00 310.00 0.00 0.0000 0.0000
Terra 408.96 0.00 408.96 0.3200 1,278.0000 square foot
Fire District Impact Fee 1,334.21 0.00 1,334.21 1,321.0000 1.0100 Peak PM Trip
Traffic Facilities Charge 3,093.00 0.00 3,093.00 3,093.0000 1.0000 ERU
Sewer ERU (LID) 1,200.00 0.00 1,200.00 1,200.0000 1.0000 ERU
Water ERU Quadrant
TOTAL FEES: 58,424.38
Applicant's Affadavit:
I certify that I have read and examined the information contained within the application and know the same OFFICIAL USE ONLY
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:
Sigeature ,~~ ~ Date Date: ~' ~ a
/- zo -r~s
Firm -~ / - - ~~ , By:
`~ _. _ ... d, l ZaQ_~._
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Applicant:
Name: Tahoma Terra, LLC
Address: P.O. Box 627
Project Information:
Project: Tahoma Terra, Division I, phase II
Description of Work: SFR lot 121 Plan 948 B,
Site Address: 14459 100th Ave, SE
Fees
Item Acct Code
Building Permit 100-500k 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
Sewer Inspection 805 412-343-80-00
Water Meter (SFD) 712 401-343-80-01
State Building Fee 160 001-386-00-00
Police Mitigation - 625 302-368-10-01
Tahoma Terra
105 001-345-85-00
Fire District Impact Fee
420 120-345-85-00
Traffic Facilities Charge
802 412-343-50-01
Sewer ERU (LID)
715 401-343-80-02
Water ERU Quadrant
TOTAL FEES:
CITY OF
YELM
105 Yelm Ave. W
Yelm, WA 98597
360-458-3244
RECEIPT No. 5 ~ ~~ r;1
RECEIVED
*'"**EIGHT THOUSAND FOUR HUNDRED TWENTY FOUR DOLLARS & 38 CENTS
FE ;E!VFD FROM PATE RFC NO
TAHOMA TERRA A~~nouN1 REF. NO
01/20/09 58091 8.424.38 CHECK 1009
P.O. BOX 627
RAINIER. WA 98576 BUDGETARY
City: Rainer
Assessor Parcel No.
Permit Fees Schedule
Permit No: BLD-09-0009-YL
~~z~ I
Phone: 360-400-0740
State: Wa Zip 98576
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
1,011 .92 993.75 18.17 5.6000 3.2440 $1, 000
427 .54 0.00 0.00 0.0000 0.0000
78 .25 0.00 0.00 0.0000 0.0000
111 .00 20.00 91.00 7.0000 13.0000 Fixture
145 .00 0.00 145.00 145.0000 1.0000 ERU
300 .00 300.00 0.00 0.0000 0.0000
4 .50 4.50 0.00 0.0000 0.0000
310. 00 310.00 0.00 0.0000 0.0000
408. 96 0.00 408.96 0.3200 1 ,278.0000 square foot
1,334. 21 0.00 1,334.21 1,321.0000 1.0100 Peak PM Trip
3,093. 00 0.00 3,093.00 3,093.0000 1.0000 ERU
1,200. 00 0.00 1,200.00 1,200.0000 1.0000 ERU
$8,424.38
- _ _ GRETCHEN
BLD-09-0009-YL --
v~~Z
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 1 ~l ~-t S ~ /'F, ~~ ,<l~ ,4l F S~ Parcel #: 7~j~. y ~ o ~ ~® Z ~ ~ I /v
Subdivision~~~sc Z ~~/2 Lot#: I Z j Zoning; /t1~C
1 j9Vew Construction I Re-Model / Re-Roof /Addition ,_ Home Occupation Sign
Plumbing -~ Mechanical Mobile /Manufactured Home Placement Other
Project Description/Scope of Work: ,5~
Project Value: ~,}1-n/ ~ ~1~ ,~
Building Area (sq. ft) 1S' Floor /yB 2nd Floor Garage .'3~ Deck l/ w
Basement Carport Patio
# Bedrooms Z # Bathrooms? Heating: GAS/OTHER or E TR (Circle One)
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed ehvironmental checklist must accompany permit application.
GENERAL CONTRACTOR ~r4lt~~ T~P.~fI TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE
PLUMBING CONTRACTOR 7l~O 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.
Applicant's Signature Date
Owner / Contractor f 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
/O:i Yelnt Avenue West
PO Bor ? 79
Yelm, WA 98597
(360) -1.58-3835
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YELM Wq 88597
i:ierk: troy
Terminal;
Receipt• 86571
Manual Receipt;
NTAHGMA TERRA
~ANUMAATERRAA TAHOMA TERRA
PO BOX 627
RAINIER uJA 98576
1/20/2009 8:18 AM
U.-t~___Item
------ _
----____ __. Price
1 CPF2900 ~ --
05-(121 _ MITIGATION 2140.00
TAHOMA - LOl 121 - PHASE ~ DIV i
subtotal; 2140.00
Tax: 0.00
Total: 2140.00
Check 2140.00
1007
Change Due: 0.00
THANK YQU
r~FILE
CITY OF YELM INSPECTION LOG
PROJECT Tahoma Terra phase II Lot 121
PERMIT NUMBER BLD-09-0009-YL
ADDRESS 14465 100`h Ave SE
SET BACKS Date: 1-20-09
Corrections :
UNDER FLOOR ® Corrections 2-23-09
DRY WELL ®_ Corrections
FOOTING REBAR _ _®Date:_1-20-09
09
Footing ^ 1 Z'
Wall ^ g'
Required vents_ _
Corrections
WALL REBAR ®Date: 1-21-
^ 16' Other_
^ 8' Other
COMBINCD FRAME/ EXTERIOR SHEAR WALL INSPECTION
Hold downs ® 3-9-09 Shear Nailing ®
3-9-09
Frame ® 3-9-09 _
Gas/Propane ^ ,
Plumbing ® 3-18-09 Mechanical ®_ 4-20-09
Corrections:
INSULATION ^Gas ®Electric ^Other
®Foam and Seal ^Vapor barrier ^PVA
Corrections: 4-27-09
SHEET ROCK/SHEAR WALL NAIL
Corrections: 4-29-09
FINAL
®Sewer Final ®Electrical ^ Civil Final ^Landscape Final ®C of O
®Address ®Insulation ^ Site Drainage ^ Sidewalk
Corrrections: 6-8-09
City of Yelm -Building Department
~ CO CTION NOTICE
I have this day inspected this structure and these premises
~ d have found the following violations of the City of Yelm _~
~~d/or State laws governing same: PERMIT NO._ 'l f ~ ~~'--/~
Gj ~'%,
~-
~.
You are hereby notified that no more work shall be covered upon these premises until the above violations are
corrected. When corrections have been made, call for re-inspe tion at 458-8407
DO NOT REMOVE THIS TAG DATE . ~~ a' ~'
QJSP R FOR BUI1.D[NG DEPARTII~NT
~.AX ~'~ANSMISSI~N
CITE' ~F 'YELIVI
P.O. BOX 479 - 931 NP ROAD NE
XELM, WA. 98597
LI ~ 3'60-458-84 l 1
`~ FAX ~36~-45 -8 I 6
8 d
F~1,X#: PAGES; / ,including this
Cover sheet
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"~ li'you do riot receive att copies or any copy is nat legible, please call (360) 458-841 I
as soon as possibic.