BLD-05-0142
~~
CI1''f Of 'fELtJI- 61.11LOltlG OEPM~1'tJlEtl1'
RESIOEtl1'I~L CER1'lfIC~ 1'E Of OCCI.lP ~tlC'f
Building J\ddress
~
~s~
~~
~
~
plan Number
owner Name
Owner J\ddress
Building permit Number
~
RemarKS.
----
NI Code reQuired
~
}\feas Inspected
specIal conditions
Date
Building OHicial
~
. . e Inte'natiOnal Residential Code (COapte'
10iS st'Uctu,e is in con,pl\ance ~'\tI ~ ton state BUIlding Code councll pursuant
5~-5~ \NJ\C) as adopted '0'1 ~2n7ea d~;~2 RON effective Jul~ ~,2004
to cnapters ~9. an '
-~~.
CITY OF YELM INSPECTION LOG
C PROJECT ;;J 87 Yl
PERMIT NUMBER C>~- (;> I t/;L.J
J$~$~ 'leu" /'" Sc
ADDRESS / ///'4 (_)/1 ,
:>
~t'\\(V
SET BACkS
Front
Rear
SIde Flanlmg
SIde
FOOTING WALL
~ 12" CJ 6"
2"16" W8"
o other 0 otr5r
o requIred \ ents / y -
W\LLREBAR VDate~
FOOTI~G REBAR Date
C0!"'~~e!'!~
c
CO'tBI~[D FRA'tE/ EXTERIOR SHEAR WALL I\SPECTIO"j
Hold dO\\"ns ~ / Shear Nailing [J
Frame ~ ~~ Gas'Propane- If':.J f'11]
Plumbing , f"^" ~ l Mechanical /; I
Comments]1~ 'l~~ Co-{'^---'
?!J
J
I~Sl LA TIO~ fJ Gas
7 Foam and Seal
Comments ~^., qPJ t ('
SHEET ROCK/SHEAR \VAlL :\AIL
~ Electnc
~ Vapor barner
CJ Other
')/ P\' -\
Comments
OTHER
Comments
FI~AL
o Sewer Final
o Address
Q Electncal
o InsulatIOn
o Cml Final
o SIte Drainage
o landscape Final
:J Slde\\ alk.
o (0[0
Comments
c
~;-E- W f:=-- K_ 0)e pT- .
05 - s~9() · 00
(S/S:L ~t::(M\E1U.A w*'11
uO.N Billk/!"'- ~-gJ2.t0
'r'cL~1 SEWER DEPT
Nov 21 2005 03 24PM P1
FAX NO 360-458-El166
FAX TRANS~1ISSI0N
CITY OF YELM
P.O. BOX 479 -" 931 NP ROAD NE
b YELM, W ^ 98597
.MJ V 360~458~8411
~ II \, I FAX 360-458-8166
TO a;;j(E)f~,-J DATE. ! I__?t-vc:;;-
FAX#: L\S~ t{3 cfe)
PAGES: I , including this
Cover sheet
From:
Subject:
COMMENTS
~z I "') {/ j;
c~ ~ fc~~-------- /~
() C'V./~
I
** If you do not r~cclve all copIes or any copy IS not legible, please call (360) 458~8411
us soon as possible
I
.l I \ ill
I~, t t~;,1
'~~
~
-=:1r.-
2:
~t"
:~"
~-glt
o
o
~
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0142-YL
Issue Date 05/18/2005
(Work must be started within 180 days)
Receipt No
36769
ApplicClI!!~...
Name: Evergreen State Builders
Phone.
253-475-6622
Address. POBox 39753
City' Lakewood
State. WA Zip 98499
Pr()p'~rty Information:
Site Address. 15752 Yelm Terra Way SE
Assessor Parcel No. 85840008900
Subdivision: Yelm Terra
Lot: 89
Contractor Information.
_..m................................. ,........................................"
Name. Evergreen State Builders
Contact: McCullem, Tom
Phone. 253-475-6622
Address. P.O. Box 39753
City' Lakewood
State: WA Zip. 98499
Contractor License No. EVERGSB980PB
Expires. 10/02106275
Business License. 1042.0
Pr()j~ct Information
Project: Yelm Terra
Description of Work: Plan 2502 S/2, Lot 89
Sq. Ft. per floor' (1st) 1034
(2nd) 1467
(3rd) 0
Garage 461
Basement 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 1,408.90 993.75 41515 5.6000 741340 $1,000
Building Plan Review 595.26 0.00 000 o 0000 o 0000
Mechanical Permit 78.75 0.00 000 o 0000 o 0000
Plumbing Permit 132.00 2000 112.00 7.0000 16.0000 Fixture
Sewer Inspection 145.00 000 145.00 145.0000 1 0000 ERU
Water ERU 1,500.00 000 1,500.00 1,500.0000 1 0000 ERU
Water Meter (SFD) 300.00 300 00 0.00 0.0000 0.0000
Water Deposit 4000 40.00 0.00 o 0000 0.0000
Traffic Facilities Charge 757 50 0.00 757 50 750 0000 1 0100 Peak PM Trip
Sewer Deposit 50.00 5000 000 o 0000 o 0000
State Building Fee 4.50 450 000 0.0000 o 0000
SewerERU 5,417 00 000 5,41700 5,4170000 1 0000 ERU
TOTAL FEES $10,428.91
A.PP.lic;.al!t's A.ffadavit:,
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
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.
Signature/~_ ~ Date ~-~I-ds"
Firm ~S ~
# Sets of Prints.
Final Inspection:
Date:
If ~ 2. <.. -as"
~-"
By'
o
o
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
PAID
MAY 1 8 2005
CITY OF YELM
Permit Fees Schedule
Applicant:
Name. Evergreen State Builders
Address. POBox 39753
Project Information.
Project: Yelm Terra
Description of Work: Plan 2502 5/2, Lot 89
Site Address. 15752 Yelm Terra Way SE
Fees:
Item Acct Code
Building Permit 1 00-50 Ok 032001-322-10-00
Building Plan Review 100001-345-83-00
Mechanical Permit 032001-322-10-00
Plumbing Permit 032001-322-10-00
Sewer Inspection 805412-343-80-00
Water ERU 712401-343-80-01
Water Meter (SFD) 712401-343-80-01
Water Deposit 740402-389-00-00
Traffic Facilities Charge 420120-344-85-00
Sewer Deposit 742402-389-01-00
State Building Fee 160001-386-00-00
Sewer ERU 802412-343-50-01
TOTAL FEES
Permit No BLD-05-0142-YL
Phone:
253-475-6622
City' Lakewood
State: WA Zip 98499
Assessor Parcel No 85840008900
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
-------------
1,408.90 993.75 41515 5 6000 741340 $1,000
595.26 000 0.00 0.0000 o 0000
78.75 000 000 o 0000 o 0000
132.00 2000 112.00 7 0000 16.0000 Fixture
145.00 000 145 00 145.0000 1 0000 ERU
1,500.00 000 1,50000 1,5000000 1 0000 ERU
300 00 300 00 000 0.0000 o 0000
4000 4000 000 o 0000 o 0000
757 50 000 757.50 750 0000 1 0100 Peak PM Trip
5000 5000 000 0.0000 o 0000
4.50 450 000 o 0000 o 0000
5,41700 000 541700 5,4170000 1 0000 ERU
$10,428.91
i~,I~,~~O"-" . ~.-::, roo ""'OU':"~N~.;g?l:li~':L~~"J1
If '''\ '\...~.I~, "
Ii" \~,% Y~', Ii-OM
I: f( " i ','
Il(J[~()x,l/q 67
I ' r W!' "W"'/ FlECEIPT No 367
1,~Ti;~"~~J'" ",,, "OJ
. .... n~N J'HOU:::ANLJ '}'v;O IIUNf.lHCD ,-~IXT"l ~Jt~VEN DOLLAPS [, h9 CENT::'
i il (.1 1\/11) f I [(1M
[l^Ir
REC NO.
AM' 'IIn I
Hf..F r',I')
EVERGPEEN STATE DUILDEH~ 05/17/0S J67G7
PO f:l 0 X 3 9 "7 ~\ ;\
LAKGwnOD. NA 98499 BUDGETARY
D t [l (/: r.:; (~1 4 '1 Y L
'~l'['L: I ':ii t,} 1 iL][ TEHP P, W( SE L14
10,267 (J9 CHECK
Pr.~NDING
,--- _u__u_uou_._ -----------~--,. [f-1:- ANA. '"- - ,-,.. -- -'--
fJU1HUl1311 1'9, E'LNFC\f5'n i5, IICCHFPll'l'i,'+ 7'), PLIlHJ:.-HIfTUU,
1 ~ ~ i (I, i-J/ ! I T n 300. VI I D 1;; [ 4 ~1, T R A F FF; -, ':l ( . .::; D 1:: r :) \ . :.;, T F r. r; i/ 'j I I
----- ---,- j ----- - - -- .~--- ---
:,J!TN'~P141), {'j,'CF'[1
~ I L: U U _' ,:j. J i,
r~~~~~..~-~~-
'I D~: <~~~~:'I Crry ,()l7
II \1....~. -.,,:r I..,. -
I ('>/ \. ~ 'v (~[ F-~/1r
I f' r "J Je L --,l't,~,
\ f (I He IV -lr (I -- r" '6 0
ii I I(i", Nfl (ll\"fJl HECEiPT No J tJ 7 u
L::' ':r-.-J ~i;IiUl Bili:i
I :11 I i'iLI
... . TLN THufJE.;P,t?iJ T\'liJ HUNL'PCD ;-"IX'JP{ 'jt,;.njU DOLLf\HD 1'( !)'} CEN'!',-;
f"f I f-IVLU I r'!( Hill
DAlE
~1EC NO
AMIJlIN r
nu' NO
I~'JEH(,F.r.Crj Srr\TS I3IJlLDr:;R~
It~:: I 1 7 / (/) 5 3 b 7 b 8
I (,) , :2 b I (, '1 C II E C J\
p r; IJD I N r;
t'O DUX .3'-n:5 3
LAKEI'/UUO. !.JA 9.'Al~i BUDGETAR)
BLD-l;j ~ -(i) L 4 '3" OiL
SIT E; 1 '1 J 1,,1 5 Yf; L I j T ERR 1\ v! Y :; E L 0 -.
-- -- --. ------- ------- D-lAN/'\
E'LDFr:J1Tl ":,:' I.' fLl.f:~\i~)(~'-J I~;, ltt"C'fHFlfTJ.l -j . PLIIUPR[iTllf~. oJ!llL'Pl~'j,l'I!L,HU1SiJ(J
~.! !II T f< ", C "-1. \.[ / D l~ l' 4 ~), '1' h j\ n 7 5 7 S 1;.', 'J / 0 E P 0) I" ::; '1' FEe 4 ~~ 0, '3 / E R U ~ 4 1 7
,i"l;)i='ii'''-''''''i1Y1''''#~'''''''';!Jlii-:'~''Uh~I~~,j~\~~~~''ilIf,~~.Jil';~~~''1'''.M~t'''tr:''q~J1
~&~"'.&~~~~~~~U~~"lal'''':''''H'I'"''';I~\''~~.!.'),,'',j,;,~.C:~'~1~~~~iJi!~~gt~~
f'Yf~~~) f"' IfTY, OF
/1', '~I .....,", '-
(:' j" V~i YE lL iVl
'....1) Ul'''< ,1 Y
! ! ":/IP \'V!I ltI~,,>7
~:Y~~~~'-:~:f='~~'~J ;(1(1 t1rlH P,/l{1.1
fl E ~_E.JP~r-t'ffi:-b 7-6
""...." '1'G n
'1' Ii 0 U [, t'dm
FnJ]i~ HUNljf~r~U
T\\fENTY C It..HT
---------
---
~I (:EIJ'f',j
AMUUN 1
...-~~-~~'-- ...-.--.-.........-.................
",
\
l ( r 1',1 I [,
I ie, i:.IJLl!f'H()M DArE
EVEWJREEN ,STATE BUILGER.-; 05/ J7 !~)5
p, I B (\ X J Cj -; 53
I.l\KBI'lUO D, i,U\ :1 ~ fJ y. D UDC.l~ l' A R Y
BLD W:, ~1l (L )"1
':";11'1. 1,)7':,,: '..LLti TERP/\ Wi SE L~~
J(21.4.28 91 r'IP:,c'i(
,
"-....... ----
".--------------
_._._._-~-----r,IAHA ----~----".,- _n'_____._____ ______ ____.__
I V; 'PI:-;"Lh,: j~1 ri.Ni~f.VS'?~; "}(', 1!E;"lIPRJiT7/\ 7r;, PLHBPHJ11'l":2 :J/IN:Jl'HILi,H/t=HU1'J1.)O
\;/]I'I'h.j~i(c, \',U;P4(,>-1, 'THAFf7'_" ~~~, ~::/[JI:P~;') :TFLJ~4 SO, ~./Cl{\J.'ll'/
o
o
Yelm School Distrlct
ATTN. SUSAN CROY
PO BOX 476
YELM, ~IA 98597
360-458-1900
Sold to 16755
EVERGREEN STATE 8UILDERS LLC
56622
BUILDCRS LLC EVtKGREEN STATE
5516 75TH S1 W #1
LAKEWOOD, WA 98499
# 5934 07 05/18/05
Reg #1 SalesPerson SUSAN
Item # 2900/MITIGA1ION
MITIGATION/CAPITAL PROJECTS
1 @ 6,844 00 6,844 00
CK #09706 FOR YELM TERRA LOTS 3,5,14,& 8
9
SubTotal
6.844 00
Total Due
Check
6,844 00
6,844 00
----------
----------
Thank you
PLEASE KEEP THIS RECEIPT' , !
o
o
LOT 8Cj
EVERGREEN STATE BUILDERS
YELM TERRA
15752 YELM TERRA WAY SOUTHEAST
YELM, WA
rr--_62_~--Tr
; i, - -- ,,5'-"SSL - - l i ;
I j 9:0 r-- 44 0 PATIO BELOW 7 0 _
U-kJ I DECK ABV 0
'I gl~l~ 1 0
.....1_ III 1 0
I U) II I
1 I~ ~ 1
1 I~I -+-t
I~ r-
AIN FLR
90 40 :tJ
J 60~O-~ -- i SIDEWALK
I
I
YELM TERRA WAYI SE
I
I I
~.J=======*===~~
: WATER LINE
o
"'<;f-
r<)
o
"<t
r<)
- - - - - - - - - - - - - - - - - - _1- _ _ _ _ _ _ _ _ _ _
STORM LINE
ca~ SITE PLAN
,
@ 2005 CASCADE RESIDENTIAL DESIGN, INC
@
NORT~
SCALE \' = 30'
THIS DRAWING IS BASED ON CLIENT -PROVIDED INFORMATION REPRESENTED TO BE ACCURATE
AND RELIABLE. ANY DISCREPANCIES BETWEEN THIS DRAWING AND THE ACTUAL SITE CONDITIONS
ARE THE SOLE RESPONSIBILITY OF THE CLIENT
o I'/A 0
Project Address/S7S? y.tC/~ r;;.eA'4 .......#f? ~Pa~ #. olS&V.??
Subdivision: Y e (hit 7..er {Pl Lot #. '#'7 Zoning; .,&iAt g it} --I{J/h1, / 'j
~ew Construction U Re-Modell Re-Roof I Addition U Home Occupation Sign
U Plumbing u Mechanical U Mobile I Manufactured Home Placement U Olher
Project Description/Scope of Work:~ f} If! -raM, (:} f.t!. ~ dul-, CL I
Project Value: ;l ~7/ 96""0
Building Area (sq. ft) 1st Floor/t9J "7 2nd Floor /.~ 7 Garage ~h/ Deck /zreF'
Basemlmt Carport Patio
# Bedroom~ # BatR~06ms-I Heatin~OTHER or ELECTRIC (Circle One)
Are there any environrnentalli sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER NAME. 'at"
ADDRESS _~g/S. EMAlL --s;
CITY LaIt tJtt..iYJd STATE TELEPHONE
ARCHllECTIENGINEER. ~~ :",^ICENSE #
ADDRESS ,f)l ~;Z ~ . _EMAILdl~:r6_
CITY72lCl1n7a STATE:/-:{// Z1P9.f~z TELEPHONE{-63J 2ff'/ -t5176
GENERALCONTRACTOR \.~a.s ~ TELEPHONE
ADDRESS EMAIL
CITY STATE FAX
CONTRACTOR'S LICENSE # t:14 EXP DA T CITY LICENSE #
PLUMBING CONTRACJ:.OR...,j
ADDRES~~ -CJ1~
CITY7a It. STATE
CONTRACTOR'S LICENSE #
TELEPHONE
EMAIL
FAX 2<~s:%'-9~
EXP DATE CITY LICENSE #
MECHANICAL CONTRACT9R ;S;'d~~/ RCA." .#7 TELEPHONE ZS 5 ;I 70--? J.i'CJ
ADDRESS5Sz~ /f~"" sr ~;~ -"'1, EMAIL
CITY ~y~.#~ STATE "'~'9' ZIP .,~.? 7S- FAX ';7;5'3 J7 75"- ~z;fS-
CONTRACTO '5 LICENSE # EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable
I hereby certify that the above InfOJmiltloo Is correct and that the construction DO, aod the occupancy aod 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.
/~~ ...s-;/5~g'
Applicant's Signaturt~ Date
Owner I contractor(~ 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 is!;uance, or if work is suspended or abandoned for a period of 180 days
(360) 458-3835
(360) 458-3144 FAX
www.ci.yelm.wa.UB
105 Yelm Avenue WeBt
POBox 4'/9
Yelm. WA 9859'/