20090080 Permit Pkg 060209City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant
Permit No: BLD-09-0080-YL
Issue Date: 06/02/2009
(Work must be started within 180 days)
Receipt No: 60310
Name: Yelm Property Development Phone: 360-458-0544
Address: City: Yelm State: Wa Zip 98597
Property Information:
Site Address: 9939 Bourbon St. , SE
Assessor Parcel No. 84070008100 Subdivision: Willow Glenn III Lot: 81
Contractor Information:
Name: YPD Contact: Phone:
City: State: Zip:
Address:
Contractor License No: Expires: Business Li cense:
Project Information:
Project: Willow Glenn III
Description of Work: SFR lot 81, Plan 1629
Sq. Ft. per floor: (1st) 838 (2nd) 791 (3rd) 0 Garage 400 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 1,392.32 993.75 398.57 5.6000 71.1730 $1,000
Building Plan Review 588.26 0.00 0.00 0.0000 0.0000
Mechanical Permit 78.25 0.00 0.00 0.0000 0.0000
Plumbing Permit 104.00 20.00 84.00 7.0000 12.0000 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
Fire District Impact Fee 649.28 0.00 649.28 0.3200 2,029.0000 square foot
State Building Fee 4.50 4.50 0.00 0.0000 0.0000
Traffic Facilities Charge 1,334.21 0.00 1,334.21 1,321.0000 1.0100 Peak PM Trip
Sewer ERU 6,050.00 0.00 6,050.00 6,050.0000 1.0000 ERU
TOTAL FEES: $12,145.82
Applicant's Affadavit: -_
OFFICIAL USE ONLY
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 # 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, 1 futher certify that I am currently
registered in the State of Washington. Final Inspection:
~/ ~ _ r Date:
Signature f_.~ _e.) , , ~ .~: ~ ~ ~ y Date ~~ A~ ~1'
"` nA' n By:
Firm - - ~N~t~
~-„~ ~~ -
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Permit Fees Schedule
Permit No: BLD-09-0080-YL
Applicant:
Name: Yelm Property Development Phone: 360-458-0544
Address: City: Yelm State: Wa Zip 98597
Project Information:
Project: Willow Glenn III
Description of Work: SFR lot 81, Plan 1629
Site Address: 9939 Bourbon St., SE Assessor Parcel No. 84070008100
Fees:
Item Acct Code Item Fee Base Amt
-- Unit F
-
- ee
-- Unit Rate
------- No. Units
- Unit Desc
-------------------------
Building Permit 100-500k ---------
032 001-322-10- 00 ----
1,392. --
32 -----
--
993.75 -----
-
398. 57 5.6000 71.1730 $1,000
Building Plan Review 100 001-345-83- 00 588. 26 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- 00 104. 00 20.00 84. 00 7.0000 12.0000 Fixture
Sewer Inspection 805 412-343-80- 00 145. 00 0.00 145. 00 145.0000 1.0000 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
Fire District Impact Fee 105 001-345-85- 00 649 .28 0.00 649. 28 0.3200 2,029.0000 square foot
State Building Fee 160 001-386-00- 00 4 .50 4.50 0. 00 0.0000 0.0000
Traffic Facilities Charge 420 120-345-85- 00 1,334 .21 0.00 1,334. 21 1,321.0000 1.0100 Peak PM Trip
Sewer ERU 802 412-343-50 -01 6,050 .00 0.00 6,050. 00 6,050.0000 1.0000 ERU
TOTAL FEES: §12,145 .82
CITY OF
YELM
Ye mY`WAA98597 RECEIPT No. 6 ~~~ ~ ~, Q
360-458-:3244
'j~LVE THOUSAND ONE HUNDRED FORTY FIVE DOLLARS & 82 CENTS
RECEIVED FROM
YELM PROPERTY DEVELOPMENT LLC
P.O. BOX 2950
YELM WA 98597
BLD-09-0080-YL
DATE REC. NO. AMOUNT REF NO.
06/02/09 60310 12.145.82 CHECK 10292
BUDGETARY
MICHELLE
~~FTIiEp~~ City of Yelm Permit Fees Schedule
~ 9!~ Community Development Department Permit No: BLD-09-0080-YL
~n Building Division
Phone: (360) 458-8407
ELM Fax: (360) 458-3144
Applicant:
Name: Yelm Property Development Phone: 360-458-0544
Address: City: Yelm State: Wa Zip 98597
Project Information:
Project: Willow Glenn III
Description of Work: SFR lot 81, Plan 1629
Site Address: 9939 Bourbon St., 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
Fire District Impact Fee 105 001-345-85-00
State Building Fee 160 001-386-00-00
Traffic Facilities Charge 420 120-345-85-00
Sewer ERU 802 412-343-50-01
TOTAL FEES:
Assessor Parcel No. 84070008100
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
1,392.32 993.75 398.57 5.6000 71.1730 $1,000
588.26 0.00 0.00 0.0000 0.0000
78.25 0.00 0.00 0.0000 0.0000
104.00 20.00 84.00 7.0000 12.0000 Fixture
145.00 0.00 145.00 145.0000 1.0000 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
649.28 0.00 649.28 0.3200 2, 029.0000 square foot
4.50 4.50 0.00 0.0000 0.0000
1,334.21 0.00 1,334.21 1,321.0000 1.0100 Peak PM Trip
6,050.00 0.00 6,050.00 6,050.0000 1.0000 ERU
x12,145.82
FILE
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
uy ~n ~ I SF Parcel #: ~~~, ~ C C' c ~ ~ ~ C,
Project Address: ~~ ~/ // t7
Subdivision: ~ I ~~Ow G/P:901 3 Lot #: g / Zoning; ~~~ ~
New Construction ^ Re-Model / Re-Roof /Addition C Home Occupation Sign
C Plumbing ^ Mechanical C Mobi/le~/~ Manufactured Home Placement ~ Other
Project Description/Scope of Work: SFk~' l--C:.'~ ~~ ~~ ~ l~ ~E i Z
Project Value:
Building Area (sq. ft) 1S` Floor-~"~ 2nd Floor ~R r Garage y~~C~ Deck
Basement Carport Patio
# Bedrooms. # Bathrooms,~j 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.
GENERAL CONTRACTOR 1 LAC TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
PLUMBING CONTRACTOR -iD N~ i CN TELEPHONE 5~(~- ~~0.3
ADDRESS c~ X 4 91 EMAIL
CITY IP~4tN1~~2 STATE t,c~h ZIP ~ ~~~G FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR CtN~~T/F/2 TELEPHONE c1 SE--~gS~
ADDRESS o2J L, C c ''' EMAIL
CITY LtfCE STAT t~_ZIP ~S03 FAX
CONTRACTO '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.
--Q'y7/i'Lc ~GL~-L-t ~1 ~ ~~
Applicant's S' nature 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
~~-~~~~
. 1,?dY 14.~Q9
105 Yelm Avenue West (360) 458-383.5
PO Box 479 (360) 458-3144 FAX _~
Yelm, WA 98597 wu~u~.ci.yelm.u~a.us
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YELM CP MgOX 476 HDOLS
YELM WA 98597
roY
Clerk:
Terminal: 100735
Receipt:
Manual Receipt:
NBROCKTON
NBROCKTON
BROL'KTON CONSTRUCTION LLC, YELM PROPERT
DEVELOPMENT LLC
;;!'2/2009 11:32 AM Price
i~ty__ Item ----- _-_-----
- 2780.00
1 CPF2900
MITIGATION LOT 81
U7-115 - WILLOW GLENN III - 0,00
1 CPF2900
MITIGATION YELM WA 98597
g9J9 60URBGN ST SE
Subtotal: 2780.UO
0.00
Tax:
Total; 2780.00
2780.00
Ch
10291
0.00
Cash
0.00
Change Oue:
THANK YOU