20050087 Permit Pkg 03302005City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: Lester Caldwell
Address: 1502 Yelm Ave West, #9
Property Information:
Site Address: 1502 Yelm Ave. West
Assessor Parcel No. 21713340404
Contractor Information:
Name: DBBR
Address: 316 Jackson St.
Contractor License No: DBRIN"044JQ
Project Information:
Project: Sunrise Vista
Description of Work: 41x66 Mfg. Home
Sq. Ft. per floor: (1st) 0
Heat Type (Electric, Gas, Other):
Fees:
Item
---------------------------
Building Permit -Other
TOTAL FEES:
(2nd) 0
City: Yelm
Subdivision: Sunrise Vista
Contact:
City: Centralia
Expires: 04/10/06100
(3rd) 0
Item Fee Base Amt Unit Fee
----------- ----------- -----------
150.00 0.00 0.00
$150.00
Permit No: BLD-05-0087-YL
Issue Date: 03/30/2005
(Work must be started within 180 days)
Receipt No: 36011
Phone: 458-1565
State: WA Zip 98597
Lot: 9
Phone: 360-269-3877
State: WA Zip: 98531
Business License: 846.0
Garage 0 Basement 0
Unit Rate No. Units Unit Desc
----------- ----------- -------------
0.0000 0.0000 $1, 000
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 d. If applying as a contractor, I futher certify that I am currently
registerg/MR1'tT11~S~{~ in n.~ e
Date ~ • ~ ~ ~!
OFFICIAL USE ONLY
Sets of Prints:
final Inspection:
Date:. ~~/~' ,~~
Firm
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Applicant:
Name: Lester Caldwell
Address: 1502 Yelm Ave West, #9
Project Information:
Project: Sunrise Vista
Description of Work: 41x66 Mfg. Home
Site Address: 1502 Yelm Ave. West
Fees:
Item Acct Code
--------------------------- --------------
Building Permit -Other 032 001-322-10-00
TOTAL FEES:
City: Yelm
Permit Fees Schedule
Permit No: BLD-05-0087-YL
Phone: 458-1565
State: WA Zip 98597
Assessor Parcel No. 21713340404
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
---------- ----------- ----------- ----------- ---------- -----------
150.00 0.00 0.00 0.0000 0.0000 $1,000
5150.00
i~ °¢ `yfpq CITY OF
'~' 9
i YELM ~
P.O. Box 3; 9 ~
3 6 011
RECEIPT No
Y~Im, WA ~RFg, ~
.
YELM 350-4:^~-8x03
i
I
r ~
R~CE~VED
****ONE HUNDRED
FIFTY DOLLARS & 00 CENTS ~
?~CE,V~C SRO;,,' DATE REC. NO. A?lOUNT REF. ~;0.
LESTER CALDWELL 03/30/05 36011 150.00 CHECK 7222
1502 YELl4 AVE W #9
YELM, WA 98597 ~
SITE: 1502 YELM AVE W
MISCELLANEOUS RECEIPT
MICHELLE
BLDG PRi~tT 150.00
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OAKWOOD HOMES Fax:3604382184 Feb 28 2005 16:02 P. O1
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AUG-14-2003 07:28 Yelm CDD 360 459 3144 P.03
CITY OF YELN
RESIDENTIAL BUILDING PERMR APPLICATiIpN F?ORM j~
Project Address: ~~ e% C Parcel #: ~~ ~~ ~~.1 ~~7 ~ ~ ~ ~v e, d
subsivision: Lot#: ~ zoning; MAR 1 5 2005
u New Construction u Re-Model / Re-Roof / Addit~n IJ Home Occupation Sign
u Plumbing U Mechanical t.Lldl'obile ! Ma`n~ufactlured Hom. Placement U Other
Project DescrlptioNSoope of Work:~'v~~lrt -~4 71 ~ lo~~ ~b~~f
Project Velue• ~~. G~
r
Bulkiing Area (sq. ft~ 1'~ Floor V 2n0 Floor Garage = Deck
Basement Carport Patio
~ Bedrooms ~ # Bethraoms, ~ Heating: GAS/OTHERro LECTRI Circle One)
Are there any environmer~ally sensitive areas located on the parcel? If yes, a
completed environmertital checklist must aooompany permit application.;
BUILDING E•
ADDR i z?IkiJ EMAIL
CITY STATE /ZIP ~ TELEPHONE i
ARCHlTECT/ENGINEER LICENSE # _ _
ADDRESS EMAIL
CITY STATE 21P TELEPHONE ~
GENERAL I F~1 ~ TELEPHONE ~ ~~
App ~ - 4C ' ~ EMAIL
CITY ~~ i STA P FAX ' ~/
CONTRACTOR'S LICENSE # ~J ~ DATE - LICENSE # dt ~7~ ~ P
PLUMBING CONTRACTOR TELEPHONE_
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE_CITY LICENSE #
MECHANICAL CONTRACTOR
CITY • STATE ZIP,
CONTRACTOR'S LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable.
I Ilaretry oertliy That the above Inforngtbn Is comet and tfiat the eonstruetlon on, and the occupancy and the use of tl-a
above deserlMd property wNl be In accordance whfi the laws, nrNs and regulations of the State of Washington and tfie
City of Yel
~ - l
Applicant' ~~ - -
Owner / oMracto /Owner's Agent /Contractor's Agent (Please alrcle one.)
Ail permits are non-transftrable and wYl expire if work auehorized by such permit is not begun
within 180 days of Issuance, or if work is suspended or abandone/1 fvr a peHod of 180 days
106 Yslm Aosnas Wsst (360) ~Sd-3dd5
PO Bor !79 (360) !58.41 ~~ FAJC
Yelrn, WA 98597 roww.el,YSim,ws.w
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General/Specialty Contractor
A business registered as a construction contractor with LEtI to perform construction work within the scope
of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment
of account and carry general liability insurance.
License Information
License DBRIN`*044JQ
Licensee Name D B &r R INC
Licensee Type CONSTRUCTION CONTRACTOR
UBI 601692387 Verify. Workers_Co~ Premium
Status
Ind. Ins. Account
Id
Business Type CORPORATION
Address 1 316 JACKSON ST
Address 2
City CENTRALIA
County LEWIS
State WA
Zip 98531
Phone 3607368542
Status ACTIVE
Specialty 1 GENERAL
Specialty 2 UNUSED
Effective Date 4/18/1996
Expiration Date 4/10/2006
Suspend Date
Separation Date
Parent Company
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License
Business Owner Information
https://fortress.wa.gov/lni/bbip/Detail.aspx?License=DBRIN* *044JQ 3/15/2005
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Name
YOUNG, DAVID B
Bond Information
Role ~ Effective Date ~ Expiration Date
101/01/1980 1
Page 2 of 3
Bond Bond
Company Account Effective Expiration Cancel Impaired Bond Received
Bond Name Number Date Date Date Date Amount Date
AMERICAN
CONTRACTORS Until
#4 INDEMINIT 210244 04/10/2004 Cancelled $12,000.00 04/09/2004
Until
#3 CBIC SA2369 03/11/2002 Cancelled 04/10/2004 $12,000.00 03/11/2002
#2 CBIC SA2369 04/10/1998 03/11/2002 $6,000.00
#1 CBIC SA2369 04/10/1996 04/10/1998 $6,000.00
Savings Information
No Matching Information
Insurance Information
Company Effective Expiration Cancel Impaired Receive
Insurance Name Policy Number Date Date Date Date Amount Date
CLARENDON
AMERICA GNW46-
#5 INS CO 0060000496 10/01/2004 10/01/2005 $1,000,000.00 01/17/20
OHIO CAS
#4 INS CO BHO 53046556 01/13/2004 01/13/2005 $500,000.00 01/12/20
OHIO
CASUALTY
INS
#3 COMPANY BHOQQ00029420 01/13/2003 01/13/2004 $500,000.00 01/24/20
ZURICH INS
#2 CO Q78069704 01/30/2002 01/30/2003 03/11/20
#1 CBIC INSSA2369 04/10/1996 04/10/2002 01/28/2002 04/16/20
Summons /Complaints Information
Tax
Summons / Cause Warrant Dismissal Complaint Complaint Judgement Judgeme
Complaint Number Id Plaintiff County Date Date Amount Date Amoun
SUZANNE
D
#3 052002538 SWANSON THURSTON 02/07/2005 $0.00 $0.00
NATL
ASSOC OF
CREDIT
#2 042000432 MNGT KING 05/10/2004 01/08/2004 $2,220.46 $0.00
BAKER,
RICHARD
#1 032014441 t* NORA LEWIS 11 /24/2003 $0.00 $0.00
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