BLD-05-0110
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C\1"'l Of 'lEVA _ B\lI\.OIl-lG OEt> I\.R1tJ\E"'1
RESIOE"'111\.\. CER11flCI\. 1E Of ocC\lP I\.",C'l
eui\ding Address
~5808 ~04\1I Me. Sf
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owner Name
Owner fl--ddress
p\an Number
eUi\ding permit Number
Remar\<.s
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p..\\ Code ReQuired
seotember 26 2005
fl--reas \ns?ected
None
Qate
s?ecia\ conditIOns
eui\ding Omcia\
. . ne InleTnalional Residenlial Code (cnaplel
iniS sllUcluTe is in co",pllance ;,t ~. Ion Slale BuildIng Code CouncIl pursuanl
5~-5~ \Nfl--C) as adO?ted b'J \2f17ea d~;;'~2 RON elleclive JuIY~, 2004
to Cfla?ters ~9. an I
G. carlson
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FROM YELM SEWER DEPT
FAX NO. 360-458-B166
Sep 06 2005 04 29PM Pi
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FAX TRANS'MISSION
TO:
CITY OF YET.'vf
P.O. BOX 479 - 931 NP ROAD NE
YELM, WA 98597
360-458-841 '\
FAX 360-458-8166
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PAGES' ( , including this
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Subject rU-JAL5/YeLm /1:1Lfc..f)
r SLj \(:) D
COMMENTS 2-e>T Lf~ /)771.( jDLI!11 Aut;:, S.~. c5 - r7-
LOT
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*~ If you do not rccclve all COpIC~S or any copy IS not legible, please call (360) 458-8411
as soon as possible.
FROM YELM SEWER DEPT
FAX NO. 360-458-B166
Sep 06 2005 04 29PM Pi
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FAX TRANS'MISSION
TO.
CITY OF YET.'vf
PO. BOX 479 - 931 NP ROAD NE
YELM, W A 98591
360-458-84\ '\
FAX 360-458-8166
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DATE CJ-~-o~
FAX#.
PAGES' ( , including this
Cover sheet
From' R..AAJOY
Subject. rU-JAL5/YeLm /1:1'-(,-1\
COMMENTS. 2-e>T Lf~ /)77'( jDLI!11 Au€;:, S.E. (::5-SLI;).DD
LOT
4- Lf) I S-)g Co
/ 6'-1ni Au E'. s-. e:- 05 €JL/L/Oi[>
It 0 00
Ibl.(1JdAuE s_c (6-5t.J
LDI
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H If you do not rccclve all COplCS or any copy is not legible, please call (360) 458-8411
as soon as possible.
CITY OF YELM INSPECTION LOG
0 PROJECT W tftl '-It "'1~IO
PERMIT NUMBER C9S'- olt(9
ADDRESS If' 80 ~ I () L/ t::h fJ v<. t5E
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-<<~~ VV
SET BACKS Date
Front
Rear
Slde'Flaru.mg
Side
FOOTING
2-D Ql2"
25 ~6"
.j~ 0 other 0 other
'1 0 requITed, ents z..l -
/ Date ~ WALL REBAR ~ate 5j1J?
WALL
Q 6"
)6 8"
FOOTI"\G REBAR
C0l"!~~e!:.~s
CO\lBI;,\ED FR.\!\lEI EXTERIOR SHEAR WALL I\SPECTIO~
Hold downs 'J ~. Shear Nailing D /
F rame (Z!'C;:~ j) . I Gas 'Propane ;r aJv-/1) I t /.f"
PlumbIng "7 .', J (, Mechamcal Q I
o
Comments
I\Sl LAT10~
J Gas
o Foam and Seal
iJ ElectrIC
~ Vapor barner
n Other
:= PV-\
Comments
SHEET ROCK/SHEAR \V .\lL ~AIL
Comments
OTHER
Comments
F1~AL
Xll Sewer Final it Electncal
Address jf Insula~lon
Comments -t;~. h
o Cn Il Final 0
o Site Drainage []
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City ofVelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0110-VL
Issue Date 04/15/2005
(Work must be started within 180 days)
Receipt No
36181
ApplicCint:
Name, Evergreen State Builders
Phone:
253-475-6622
Address, P.O Box 39753
City' Lakewood
State: WA Zip 98499
Pr()perty Information:
Site Address, 15808 104th Ave SE
Assessor Parcel No 85840004600
Subdivision, Yelm Terra
Lot: 46
Contractor Information:
Name' Evergreen State Builders
Contact: McCullem, Tom
Phone: 253-475.6622
Address, P.O. Box 197
Contractor License No, EVERGSB980PB
City' Lakewood
Expires, 10/02/06275
State, WA Zip 98499
Business License: 1042.0
Project Information
Project: Yelm Terra
Description of Work: Plan 1610 R/2B , Lot 46
Sq, Ft. per floor' (1 st) 1610
(2nd) 0
(3rd) 0
Garage 470
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 1,09090 993 75 9715 5 6000 17 3490 $1,000
Building Plan Review 460 90 000 000 o 0000 o 0000
Mechanical Permit 7175 0,00 000 o 0000 o 0000
Plumbing Permit 111 00 2000 9100 7 0000 13.0000 Fixture
Sewer Inspection 145,00 0,00 145,00 145 0000 1 0000 ERU
Water ERU 1,500 00 0,00 1,50000 1,500 0000 1 0000 ERU
Water Meter (SFD) 300 00 300 00 000 o 0000 o 0000
Water Deposit 4000 40,00 000 o 0000 o 0000
Traffic Facilities Charge 757,50 000 757 50 750 0000 1 0100 Peak PM Trip
Sewer Deposit 5000 5000 000 0.0000 o 0000
State Building Fee 450 450 0,00 o 0000 0,0000
Sewer ERU 5,41700 000 5,41700 5,417 0000 1 0000 ERU
TOTAL FEES. $9,948.55
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
Yelm regulations including those governing zoning and land subdivision, and in addition, all covenants,
easements and restrictions of record If plying as a contractor I futher certify that I am currently
registered i of Washington,
.
# Sets of Prints.
Date
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Final Inspection: ~
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Yelm School District
ATTN SUSAN CROY
PO BOX 476
YELM, ~JA 98597
360-458-1900
Sold to' 16755
EVERGREEN STATE BUILDERS LLC
56622
BUILDERS LLC EVERGREEN STATE
5516 75TH ST W #1
LAKEWOOD, WA 98499
~ 5867 13 04/15/05
Reg #1 SalesPerson BONNIE
Item # 2900/MITIGATION
MITIGATION/CAPITAL PROJECTS
1 @ 3,422 00 3,422 00
Yelm Terra - Lots 41 & 46 ck#9517
Item # 2900/MITIGATION
MITIGATION/CAPITAL PROJECTS
1 @ 5,13300 5,13300
Yelm Terra - Lots 56, 58 & 59 ck 9438
SubTotal
8.555.00
Total Due
Check
8,555 00
8,555.00
----------
----------
Thank you
PLEASE KEEP THIS RECEIPT'"
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: Evergreen State Builders
Address, POBox 39753
Project Information
Project: Yelm Terra
Description of Work: Plan 1610 R/2B , Lot 46
Site Address, 15808 104th Ave SE
Fees:
Item Acct Code
Building Permit 100-500k 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 420 120-344-85-00
Sewer Deposit 742402-389-01-00
State Building Fee 160001-386-00-00
Sewer ERU 802 412-343-50-01
TOTAL FEES.
Permit Fees Schedule
Permit No BLD-05-0110-YL
Phone:
253-475-6622
City' Lakewood
State, WA Zip 98499
Assessor Parcel No, 85840004600
Item Fee Base Amt Unit Fee Unit Rate No Units Unit Desc
-------------
1 090,90 993,75 9715 5 6000 173490 $1,000
460 90 000 000 o 0000 o 0000
7175 000 0,00 o 0000 0.0000
111 00 2000 9100 7 0000 13.0000 Fixture
14500 000 145,00 145.0000 1 0000 ERU
1 500,00 0,00 1,50000 1 500,0000 1 0000 ERU
300 00 300,00 000 o 0000 o 0000
40,00 40,00 0,00 o 0000 o 0000
757,50 000 757,50 750,0000 1 0100 Peak PM Trip
5000 5000 0.00 o 0000 o 0000
450 450 000 0,0000 o 0000
5,41700 000 5,41700 5,4170000 1 0000 ERU
$9,948.55
!~
f PAID
APR1i J:
JL fJ 2005
CrrY'f1I,f""
\\JI,r )Y:$Lfv1
03/30/2005 15 23
253284,:U 83
U
CASCADE RESIp~AL
PAGE 03
LOT 46
EVERGREEN STATE BUILDERS
, YELM TERRA
I
1880S! l04th AVENUE SOUTHEAST
SITE PLAN APPRQVAL YELM, WA
'~~ROVED AS-PR,S(!!!~IO REVISE >N" R'SU'~T,
R,VIf,W[p ll'I' [CUtN!),
DAT~~
NOTF,~;
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60.00'
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____~_~___ I
STORM ILlNE -------'-----,--- ----
I 104th A VLSE. I
-:----~---- I (.;;l-I
-W-ATER-'PNC -, - - ---- --=-=-::: --- - --'-=-- - ~
~ !
!~~Y~~I~ SITE PLAN
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@
NORTH
@ 2005 CASCADE Rf_SIDEI\ITI.4L DESI(;N, INC
i
THIS DRAWING IS BA5ED ON CLIENT ~PRO\'IDW INFORMATION ~[f!RESENTr.~ TO 9E ACCURATE
M'C RELlAAI.[. ANY DISCRErANGIES BETWEEN THIS DRAWING A~O THE ACTUAl, "ITE CONDitiO"'
ARE THe $OLt RESPONSlelLity OF THE CI.I,NT '
SCALE I' ~ 3g'
O C:J
~~ ~ r $/
ProjectAddress:/.5&~b /~ ~ ,4-v6 /,{E' Parcel#'
Subdivision: yel'wt1-:er(PL lotN' ~6 Zoning; ~~ Ie ---f{1/tr(J I':)
~ew Construction U Re-Modell Re-Roof J Addition u Home Occupation Sign
U Plumbing u Mechanical U Mobile I Manufactured Home Placement U Other
Project Description/Scope of Work: ~~,~ ~ktll' {:} ~ :5.-1 du...l, Cl_1
Project Value: 2./~ . <9..5"'t::J
Building Area (sq ft) 1st Floor/b'~ 2nd Floor Garage "Y7eJ Deck
Basement Carport Patio Z/6
# Bedrooms J, # Bathroomsk Heating~THER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER NAME.
ADDRESS
CITY
ICENSE #
EMAll
TELEPHONE
GENERAl CONTRACTOR \~ a.s C/11ft.IJr TELEPHONE
ADDRESS EMAll
CITY STATE FAX
CONTRACTOR'S LICENSE # EIA EXP OAT' i'h CITY UCENSE #
PLUMBING CONTRACrOR.-J '
ADDRES~~/~-<~ r
CITY72l YJ1 STATEUAl
CONTRACTOR'S LICENSE #
TELEPHONE ~'
EMAIL
ZIP9'8'V~S-- FAX 2<::;;~-9.?~
EXP DATE CITY LICENSE #
MECHANICAL CbNTRACTOR~""'pI' #'-.,. TELEPHONE "Z.f 1- S 70'- .TJcS"'t:J
ADDRESSS"d"z," /1"~S77 L A - EMAll
CITY ~""'//-;JJ1!? STATE~ ZIP ?.#37.r FAX .::..5.., .. ~'6'-e,.z.L$'
CONT CTOR'S LICENSE # EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools. jf applicable
I hereby certify Ihal the above Information is correct and thm the construction on. and the occupancy and the USG of tl\ll
above descrtbed property will be In accordance with the laws, rulDS and regulations of the State of Washington and the
City of Yelm.
/~~ ~-S=6>S;;--
Applicant's Signature .---....... 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 issuance, or If work is suspended or abandoned for a period of 180 days
105 Yelm Avenue West
PO&x 479
Yelm. WA 88597
(360) 458-3835
(360) 458-3144 FAX
www.ci.Yl.lm.wa.WI