20130227 Permit Pkg 06122013 City of Yelm Permit No.: 20130227
Community Development Department Issue Date: 6/12/2013
�. (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
"'": °" Fax: (360)458-3144
Applicant:
Name: FREESTONE CHERRY MEADOWS LLC Phone: 253-896-1300
Address: 6820 20TH STREET E
FIFE WA 98424
Property Information:
site Address: 15423 91 ST AVE SE 167 Owner: FREESTONE CHERRY
MEADOWS LLC
Assessor Parcel No.: 41610016700 Subdivision: CHERRY MEADOWS Lot: 1'67
Contractor Information:
Name: FREESTONE CHERRY MEADOWS LLC Phone: 253-896-1300
Address: RICK CARLILE
6820 20TH ST E STE A
FIFE WA 98424
Contractor License No.: FREESI'`969NZ Expires: 1/24/2011
Project Information:
Project: NEW RESIDENTIAL BUILDING
Description of Work: LOT 167, PLAN 2379A 3C
Sq. Ft. per floor: First 984 Heat Type(Electric, Gas, Other): GAS
Second 1395
Third
Garage 576
Basement
Fees:
Item Contractor Fees
NEW RESIDENTIAL BUILDING FREESTONE CHERRY MEADOWS LLC $16,570.11
MECHANICAL KLIEMANN BROS. $ 78.25
PLUMBING PELTRAM PLUMBING $ 118.00
TOTAL FEES: $16,766.36
Applicant's Affidavit: OFFICIAL USE ONLY
I certify that 1 have read and examined the information contained within the application and know the same
to be true and correct. 1 also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints:
Yelm regulatiora�in luding those governing zoning and land subdivision, and in addition,all covenants,
easements and re rictions of record. If applyin �as a contractor, I further certify that I am currently Final Inspection:
registered i�i t ate of Washi n.
� � Date:
Signature Date
Firm By�
Cit� �f y�lm
(36 ) 4J�3-8�l02
�L�#: Gi11:if)07(J 6I11J2U13 9:40 A�1
n�E�r�: r�o r�ar�: am
R��#: �z:3u
r�frahr: :3;�.ur�rio au���zNra p���Mrrs
20 i3!)7.27 1�,lti6.3�,GR
Fl�E�51�t?lak C'}lEF;�;"� MC�AD04�S ll.0
154�3 �1�T� AU� SE 167
�LD-RCS 1 76,57C1. 11Cf�
����'H 78,25CR
P� 118,OOCR
i�f�AN; :i3,��i:)� ►�UrI.DINLa PERMITS
20�1:3�)228 �7,127.20CR
F�(�'E�STONE CFIEI��Y f�I�A�0��5 {_LG�
15318 91ST ,AVE SE 164
E3LU-�RfSI 16,92I,95CR
M��'�� 81.25Ck
PL 11 i��QOC�
)EN()ERE[.): �33,8ti,3,ata CH�GK
AW�I IEl�: ;3J,89�,5�_
i�HNNGE; __ .. _____. _�____..._..
0.00
YELM COMMUNITY SCHOOLS
PO BOX 476
YELM WA 98597
Clerk: Croy
Terminal: 212472
R�ce�pt,
Manual Receipt:
NFREESTONE
NFREESTONE
FREESTONE, ��C
F�F�,�WA�9642A SUIT�. A
�/12/2013 9;25 AM
Price
Qt�_._.._I tem.��__.�..___._---_...�_____-—
-" 3015,00
1 MITIGATION ION
03-021ILOT 16Q/15318 915T AVE 5E�3015.00
1 MITIGATION�ON
03-021/LQT 167/15423 915T AVE SE;YELM
5ubtotal: 6030.0�
0,00
Tax: �030.0�
l�otal:
Che�k 6030.00
2231
� Change Due: 0.00
THANK YOU
�,o��a.a�
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
� Project Address:_L�J'7o�.� R���Q.^� Parcel#: "C��(t�C� I(o�I ��
Subdivision: �ot#:�� Plan#:J� Zoning:
�Q New Construction ❑ Re-Model/Re-Roof/Additio� ❑ Home Occupation Sign
❑ Plumbing ❑ Mechanical ❑ Mobile/Manufactured Hom lacement ❑ Other
Project Description/Scope of Work: � � Q
Project Value: �, �2iS . �
Building Area (sq. ft) 1 g�Floor I a� 2"d Floor��J Garage 5 1 _ (Q�
Basement ---� Carport —� Pati�/��a _ ,
#Bedrooms�"� #Bathroomsd�� Heating: AyS OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? �_
/fyes, a compieted environmental checklist must accompany permit application.
au���irv�,awrv��rtAM�:
ADDRE S O EMAIL ' ,��
C�N � STATE ZIP TELEPHONE (o_(,�_
ARCI-�1�'�E�T/��IGt�V�EF� LICENSE#
ADDRESS :1 - EMAIL tiv�er�q CqfV�C.q,.�,
C�TY Bo�-h�1 STATE ZIP � TELEPHONE "�
GENER�L,C4NTF�ACT�F� TELEPHONE 5pt =
ADDRESS EMAIL �{m
CITY 5Pr11�1'c STATE IP F,qX �o2ii.�gc�(o-b(o gp
CONTRACTOR'S LICENSE# E 2 EXP DATE CITY LICENSE#
�l
PLIJMBIN�CQNTRi4�T�i� t LEPHONE 1-
ADDR SS EMAIL
CITY STAT Z P � t FAX (25�, 9 L-Q�
CONTRACTOR'S LICENSE# O EXP DATE CITY LICENSE#
1 �p
M�CHANIG�AI�GOI`�'TRi��TOF� • K � TELEPHONE a6 5 -O
ADD�SS 0 '� ' EMAIL
CITY I�ry�q., STATE ZIP L FAX C
CONTRACTOR'S LICENSE#{!t,rE�+1P�{�0 1 E�T EXP DATE.I� CITY LICENSE#
� a."1 21�1�{
Copy of mitigation agreement with Yelm Commurnty Schools, if applicable.
1 hereby certlfy that the above Informatlon is correet and that the constructlon on,and tha oeeupancy and the use of the
above ribed property wlll ba in accordanco with the laws,rules and regulatlons of the Stata of Washington and th•
Clty f Ye .
/� /
Appii t's Signatur Date
Owner/Contractor/Owner's Agent/ ontractor's Agent(Please c(rcle one.)
All permits are non-transferable and will expire tf work authorized by such permit is not begun
with(n 180 days of issuance, or If work is suspended or abandoned for a p
�;���- -
`� : _ __.
a MAY 3 0 2�13 ;
105 elm Avenue Weat
�.-- -
Yelm, WA 98597 (360).f58-3144 FAX
www.ci.yetm.wa.ua
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APPROXIMATE�FR � \,s� STEP TANK EXCAVATION IN VIOLATION
LOCATION OF � OF THE REQUIRED 5' MINIMUM SET BACK
STREET TREE I TO FOUNDATION SHALL BE BACKED
�'�� � FILLED WITH CDF.
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DRAINS TO DRYWELL
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9/S� ��iF'�� i� � 1��� ! FOR SET BACK INSPECTION.
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�'`s� L4T ;��� _:-_=�.k� RY M EAD�WS
PARCEL #: 416100�67 00 DQte: oWner: �reestone
_ 05 / 24 /13 Gherru Meadows LLG
Lot S(ze: Pro�ect Address: 68 220 Oth St. E Svlte A
Fife, WA Q8424
7,$99 Sq. Ft. 15423 91st AVENUE SE 253-Sqb-1300
Sep.25.2013 07:52 AMI PAGE. Z
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Home Buitders Address:
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Nov.27.2013 10:39 AM PAGE. 2/ 2
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