20080392 Permit Pkg 120808yoF T~j°~~ City of Yelm Permit No: BLD-08-0392-YL
~~ Community Development Department Issue Date: 12/08/2008
4
Building Division (Work must be started within 180 days)
Phone: (360) 458-8407 Receipt No: 57420
Y M Fax: (360)458-3144
Applicant:
Name: Yelm Property Development Phone: 458.0544
Address: P.O. Box 2950 City: Yelm State: WA Zip 98597
Property Information:
Site Address: 16808 Greenleaf Ave., SE
Assessor Parcel No. 84070007700 Subdivision: Willow Glen Phase III Lot: 77
Contractor Information:
Name: Applicant
Address:
Contractor License No: YELMPDL00302
Contact: Balascio, D M
City:
Expires: 02/2010551
Phone:
State: Zip: 98597
Business License:
Project Information:
Project: Yelm Property Development
Description of Work: SFR, Lot 77, Plan #1622
Sq. Ft. per floor: (1st) 787 (2nd) 835
Heat Type (Electric, Gas, Other): GAS
(3rd) 0 Garage 432
Basement 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Building Permit 100-500k 1,395.25 993.75 5.66 5.6000 71.6960 $1,000
Building Plan Review 906.91 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 145.00 145.00 0.00 0.0000 0.0000 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
Consumer Dep 90.00 40.00 0.00 0.0000 0.0000
State Building Fee 4.50 4.50 0.00 0.0000 0.0000
Sewer ERU (LID) 3,009.00 0.00 3,009.00 3,009.0000 1.0000 ERU
Fire District Impact Fee 657.28 0.00 657.28 0.3200 2,054.0000 square foot
Traffic Facilities Charge 1,334.21 0.00 1,334.21 1,321.0000 1.0100 Peak PM Trip
TOTAL FEES: $9,531.40 r ~I~I ~j
~l.~I tll ~1~i~
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:
Signature - /, / ~ ~~ O 8 Date:
_ ~~ __ ~ ~ (~I Date
Firm ' By:
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant
~~ Permit Fees Schedule U
~A-~
DEC $ ~oO~Permit No: BLD-08-0392-YL
Name: Yelm Property Development Phone: 458.0544
Address: P.O. Box 2950 City: Yelm State: WA Zip 98597
Project Information:
Project: Yelm Property Development
Description of Work: SFR, Lot 77, Plan #1622
Site Address: 16608 Greenleaf Ave., SE Assessor Parcel No. 84070007700
Fees:
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Building Permit 100-500k 032 001-322-10-00 1,395.25 993.75 401.52 5.6000 71.6960 $1,000
Building Plan Review 100 001-345-83-00 906.91 0.00 0.00 0.0000 0.0000
Mechanical Permit 032 001-322-10-00 78.25 0.00 0.00 0.0000 0.0000
Plumbing Permit 032 001-322-10-00 111.00 20.00 91.00 7.0000 13.0000 Fixture
Sewer Inspection 805 412-343-80-00 145.00 145.00 0.00 0.0000 0.0000 ERU
Water ERU 715 401-343-80-02 1,500.00 0.00 1,500.00 1,500.0000 1.0000 ERU
Water Meter (SFD) 712 401-343-80-01 300.00 300.00 0.00 0.0000 0.0000
Consumer Dep 740 402-389-00-00 90.00 40.00 0.00 0.0000 0.0000
State Building Fee 160 001-386-00-00 4.50 4.50 0.00 0.0000 0.0000
Sewer ERU (LID) 802 412-343-50-01 3,009.00 0.00 3,009.00 3,009.0000 1.0000 ERU
Fire District Impact Fee 105 001-345-85-00 657.28 0.00 657.28 0.3200 2, 054.0000 square foot
Traffic Facilities Charge 420 120-345-85-00 1,334.21 0.00 1,334.21 1,321.0000 1.0100 Peak PM Trip
TOTAL FEES: $9,531.40
CITY OF
YELM
P.o. Box 47s
Yelm, WA 98597 RECEIPT No. 5 7 4 2 0
360-458-3244
RECEIVED
****NINE THOUSAND FIVE HUNDRED THIRTY ONE DOLLARS & 40 CENTS
R~%61VED I=ROtv'1 DATE RL~., DdC) AMOUF;i RFF. NQ
YELM PROPERTY DEVELOPMENT LLC 12/08/08 57420 9.531.40 CHECK 6280
PO BOX 2950
YELM. WA 98597 BUDGETARY
LORI
16608 GREENLEAF AVE. SE
BLD-08-0392-YL
~~pF THFP~~ City of Yelm Permit Fees Schedule
Community Development Department
~ Permit No: BLD-08-0392-YL
Building Division
Phone: (380) 458-8407
YELM Fax: (360) 458-3144
Applicant:
Name: Yelm Property Development Phone: 458.0544
Address: P.O. Box 2950 City: Yelm State: WA Zip 98597
Project: Yelm Property Development
Description of Work: SFR, Lot 77, Plan #1622
Site Address: 16608 Greenleaf 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 ERU 715 401-343-80-02
Water Meter (SFD) 712 401-343-80-01
Consumer Dep 740 402-389-00-00
State Building Fee 160 001-386-00-00
Sewer ERU (LID) 802 412-343-50-01
Fire District Impact Fee 105 001-345-85-00
Traffic Facilities Charge 420 120-345-85-00
TOTAL FEES:
Assessor Parcel No. 84070007700
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
1,395.25 993.75 Y401.52 5.6000 71.6960 $1,000 _
906.91 0.00 0.00 0.0000 0.0000
78.25 0.00 0.00 0.0000 0.0000
111.00 20.00 91.00 7.0000 13.0000 Fixture
145.00 145.00 0.00 0.0000 0.0000 ERU
1,500.00 0.00 1,500.00 1,500.0000 1.0000 ERU
300.00 300.00 0.00 0.0000 0.0000
90.00 40.00 0.00 0.0000 0.0000
4.50 4.50 0.00 0.0000 0.0000
3,009.00 0.00 3,009.00 3,009.0000 1.0000 ERU
657.28 0.00 657.28 0.3200 2,054.0000 square foot
1,334.21 0.00 1,334.21 1,321.0000 1.0100 Peak PM Trip
59, 531.40
FILE
_p CITY OF YELM
~~~~SIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address~~~8 ts,L, l~lhe- SE Parcel #: ~ ~LA.r1 /f~ 2Z
Subdivision: ' ~ , r'~c~ ~ • ~ ; • . ;: ~ ~ Lot #:~_ Zoning; ; - '
~^~~'lVP
~, New Construction !J Re-Model / Re-Roof /Addition ~ Home Occupation ~iyp
Plumbing ,Mechanical ~ Mobile /Manufactured Home Placement ~ ~ O rV ~ .`?LUU~
Project Description/Scope
Project
Building Area (sq- ft) 15t Floor 787 2"d Floors Garage 3 Z ~ Deck
Basement Carport Patio
# Bedrooms= # Bathrooms _?.~ Heatinr~.~ GAS/OTH~;or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? ,ti'..~ If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER NAME: 'ELM `'C r'' t 'VLC '~`ti "~ ~L~
ADDRESS ~ EMAIL
CITY STATE... •~ ZIP' .~~~: ;' i TELEPHONE -:'4~+
GENERAL CONTRACTOR Yi'rJ~ ~- C TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # ._ .-;, C: ~', i E CITY LICENSE #
PLUMBING CONTRACTOR •iL~ ,V`c: ,-t t-/ TELEPHONE ~~Yb- E?f~~LS
ADDRESS , ;, l •~ '~ 7 EMAIL
CITY • ' _ STATE ':-$ ZIP ''~ %-G FAX
C~!'~ ~ i;' ~ ~_ ; ~~; =~'- := EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR .Ji.c,v;~= ; ~ r ~ TELEPHONE ~/ SL• ~l 9 SSG
ADDRESS `, ,' !t ~ , t c •~` , ' = EMAIL
CITY -' ~ic ~ STAT ~~, ~ ZIP '1 `l` SC ~ FAX
CONTRACT0~2'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.
~r~- ~, /~r jo8
Applicant's 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
l05 }'elrn avenue tiVest (360) ~/58-3835
YOT3or d79 (360) -1~1i-3l•/-! F.LI'
}'elm, 1i~A 98597 mmu!.ci;vebn.u~n.us
~ FILE
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.APPROVED
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FILE
YELM COMMUNITY SCHOOLS
PO BOX 476
YELM WA 98597
Clerk: Croy
Terminal: 1
Receipt: 85374
Manual Receipt:
NBROCKTON
NBROCKTON
BROCKTON CONSTRUCTION LLC, YELM PROPERTY
DEVELOPMENT LLC
12%8/2008 10:49 AM
tlty__ Item __ Price
1 CPF290U 2780.00
MITIGATION
07-015 WILLOW GLENN III - LOT 77
1 CPF2900 2780.00
MITIGATION
07-015 WILLOW GLENN III - LOT 76
Subtotal: 5560.00
Tax: 0.00
Total: 5560.00
Check 5560.00
6279
Change Due: 0.00
THANK YOU