BLD-05-0082
~@IDW1~3="
Cll'/' Of '/'ELtA- BUILOlt.\G OEP ARltAEt.\l
RESIOEt.\lIAL CER11flCA1E Of ocCUP At.\C'/'
Building p...ddress
owner Name
owner p...ddress
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~W~53
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Plan Number
Bu\lding permit Number
Remar"s.
---
{\\I Code ReQuired
seotember 29 2005
Ness \nspected
special conditions
None
pate
Building Official
. . . . n 10terOaliOoa' Resideotia' Code (cnapter
Inis slructure IS ,0 compllaoce ~':~i: toO state Buildi09 Code couocil pUlSuaot
M-5~ Wp...C) as adopted b'Jt 2"7e d 70:52 RON efleclive Jul~ ;.200-
to c"apters ~ 9 an '
G. carlson
~ r-;::;1 tr;5\ mID'
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CITY OF YELM INSPECTION LOG
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PROJECT
Lv- rift? \.f &1...,,-- [,vrw
--
PERMIT NUMBER D~ ~ uobZ-
ADDRESS 15~Zl.t- /Ptj tin A ~ & ~
,
SET BACKS
Front
Rear
Slde'Flankmg
SIde
FOOTING
CJ 12"
o 16"
o other
o requIred vents
WALL
o 6"
o 8"
o other
/J-;
FOOTe~GREBAR .~_ Date 3-/(-0$"' WALL REBAR jt./.Date 3-z..~-os-
Comments
COl\IBINED FRAME/ EXTERIOR SHEAR WALL INSPECTION
Hold downs [] Shear Nallmg 0 ~
Frame J Co.w. ler1-,? Gas!Propane~ l' ~/G J /,
Comm::,:mbmg _ 7:;;~ . ~:echanrcal /0 /
C Ot...,~ _ ~ ~ ",../ "'1'11"-< fjJ lie .r~.
I""Sl LA nON u Gas CJ Electnc IJ Other
o Foam and Seal [) Vapor bamer 8 PVA
Comments
SHEET ROCK/SHEAR \VALL NAIL
Comments
OTHER
Comments
FINAL
9l Sewer Final
y Address
;If Electncal
~ InsulatIOn
o CIVIl Final 0 landscape Fmal
o Site Dramage 0 Sld~tV
J~ v-\-~
o C of 0
Comments
AW
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FROM YELM SEWER DEPT
FAX NO. 360-458-8166
Sep. 27 2005 11 52AM P1
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FAX TRANSMISSION
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CITY OF YELM
P.O. BOX 479 - 931 NP ROAD NE
YELM, W ^ 98597
360-458..R411
FAX 360-458-8166
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PAGES: I , including this
Cover sheet
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From: RA,uOl(
Subject: l4.c.lJ\':>E' r-;tJJl-~ 'fEon 1CRItA
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COMMENTS l--.oT 4q/15~~ IOl.l'Cfi Au€. 'S~-E. 65--?)l(flO 0
LoT "~}S~,q /D411! AvE. ~!E:. 6'5-5{tfjJ.~
'l'1' If you do notl'eceive all copies or any copy IS not legible~ please call (160) 458rX4 t t
as soon os possIble
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0082- YL
Issue Date. 03/16/2005
(Work must be started within 180 days)
Receipt No
35907
Applicant:
Name. Evergreen State Builders
Phone.
253-475-6622
Address. POBox 39753
City' Lakewood
State: WA Zip 98499
property Information:
Site Address. 15826 104th Ave SE
Assessor Parcel No. 85840004900
Subdivision: Yelm Terra
Lot: 49
Contractor Information:
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. 10/02/06275
Business License. 1042.0
Project InformCition
Project: Yelm Terra
Description of Work: Plan 2150 S/2 Lot 49
Sq. Ft. per floor' (1 st) 888 (2nd) 1262 (3rd) 432 Garage 0 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 1,276.77 993 75 283 02 5 6000 50 5400 $1,000
Building Plan Review 539 44 0.00 000 o 0000 o 0000
Mechanical Permit 7875 0.00 000 0.0000 o 0000
Plumbing Permit 132.00 2000 112.00 7 0000 16.0000 Fixture
Sewer Inspection 14500 0.00 145 00 145 0000 1 0000 ERU
Water ERU 1,50000 000 1,50000 1,5000000 1 0000 ERU
Water Meter (SFD) 300.00 300 00 000 0.0000 o 0000
Water Deposit 40.00 4000 000 0.0000 o 0000
Traffic Facilities Charge 757.50 000 757 50 750.0000 1 0100 Peak PM Trip
Sewer Deposit 5000 5000 000 o 0000 o 0000
State Building Fee 4.50 4.50 000 o 0000 o 0000
Sewer ERU 5,41700 000 5,41700 5,417 0000 1 0000 ERU
TOTAL FEES. $10,240.96
Appli~ant'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 applying as a contractor I futher certify that I am currently
registered in the State of Washington.
Signature/ ~ ~
# Sets of Prints.
Final Inspection:
-
Date
.r "'/~--lJr
Date:
Firm ~tI!!!!" ~
~ ~'U.
By'
~~~~~.~~~~{~C~rt;!~~~1~~~fli~~~~U'~~~
~THf~CITY OF
'7'Y 'V~I YELM
;::::/~ PO Box 479 '", 5905
~~ Y~';c;.~~~.2;gi7 RECEIPT N.J .)
RECEIVED
****TEN THOUSAND TWO HUNDRED SIXTY NINE DOLLARS & 66 CENTS
I RECEIVED FROM DATE REC NO AMOUNT REF NO
I EVERGREEN STATE BUILDERS 03/16/05 35905 10,269 66 CHECK 9389
I P.O BOX 39753
LAKErWOD WA 98499
I
I 253-475-6622
l 15892 104TH AVE SE LOT 60 HISCELLANEOUS RECEIPT
JANINE
,
BLDPER 1306.79,BLDPLN 552 12, HECH 78.75, PLUH PHT 118, SEWINSP 145,
WTRERU 1500 WTRHET 300, CONS DEP 90, TRAF 757 50 SEI'l ERU 5417 ST BLD FEE 4 5e
RECEIPT No 35906
RECEIVED
****TEN THOUSAND TWO HUNDRED FORTY DOLLARS & 96 CENTS
RECEIVED FROM
DATE
REC NO
""MOUNT
REF NO
EVERGREEN STATE BUILDERS
P O. BOX 39753
LAKEWWOD WA 98499
253-475-6622
15819 104TH AVE SE LOT 65
03/16/05 35906
10,240.96 CHECK
9389
MISCELLANEOUS RECEIPT
JANINE
BLD PMT 1276 77,BLDPLNREV 539.44, MECH 78 75, PLM 132, SEW INSP 145 ,
WTR ERU 1500, WTR HET 300, CONS DEP 90, TRAF 757 50 ST BLD FEE 4.50, SEW 5417
~~ta1tl1"'"_~~~'""'~]lm{~~r~j~I~.m~. -~~~l.r. 1.~,I~.';' '. ',' .... "'. - ~.'. -~13i~a."""'''--'.'. .e,.-..',._ '~.;;Y' ':c."'~".."'''''.'', . ..'
.~i '~~1~ t~~~~.B.z~~~:~~3~~~::~" .'. L. _=_~~.- _ _,_ ~ ~ _ ,._ _~".. _' .:. -. _'_: . ~"'_.,:r*_ '~.' ~ _!. _ e.._ ,_ ~ 0,_ '_ . - ..U _'-~. =, . ,. ,.~.~_. "._ _!,~~~~~:B.~~~~~::~1*~Btt':Rt'k;~,~~,~t~:,:
r'--,-- -- ,.". ----.. ,..---- -- -- ., . .. ,.--...... ..-- ----. ----. ... ---- .-- -. .. -- m.. ....... --- --.. ,- --...----.. . --. . ----. - - --. . _m ..... -. ----. ..--
11"~o~TH~"+:~11 CITY OF
l v.. YELM /---~
~ "'0 Rcw479 p,rg07
, 1- fe'lrn. w70: 9'5597 RECEIP No .) ~)
o "YE!-:~,",", 360-458-8403
RECEIVED
****TEN THOUSAND TWO HUNDRED FORTY DOLLARS & 96 CENTS
RECEIVED FROM
DArE
REC NO
AMOUNT
REF NO
EVERGREEN STATE BUILDERS
POBOX 39753
LAKEWOOD WA 98499
253-475-6622
15826 104TH AVE SE LOT 49
03/16/05 35907
10,240.96 CHECK
9389
MISCELLANEOUS RECEIPT
JANINE
-------------
BLDPMT 1276.77,BLDPLN 539 44, MECH 78.75. PLUM 132 . SERINSP 145 , WTRERU1500
WTR HET 300,CONSDEP 90.TRAF 757 50, STBLDFEE 4 50,SEW ERU 5417 00
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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 2150 S/2 Lot 49
Site Address. 15826 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 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 Fees Schedule
Permit No BLD-05-0082-YL
Phone:
253-475-6622
City' Lakewood
State. WA Zip 98499
Assessor Parcel No. 85840004900
Item Fee Base Amt Unit Fee Unit Rate No Units Unit Desc
-------------
1,276 77 993 75 283 02 5 6000 50.5400 $1,000
539 44 000 000 o 0000 o 0000
7875 000 000 o 0000 o 0000
132.00 2000 112.00 7 0000 16 0000 Fixture
145.00 0.00 14500 145 0000 1 0000 ERU
1,500 00 000 1,500 00 1,500 0000 1 0000 ERU
300 00 300 00 0.00 o 0000 o 0000
4000 4000 0.00 o 0000 o 0000
757 50 000 757.50 750 0000 1 0100 Peak PM Trip
5000 5000 0.00 o 0000 0.0000
450 4.50 000 o 0000 o 0000
5,41700 000 5,41700 5,417 0000 1 0000 ERU
$10,240.96
PAID
MAR I 6 2005
CITY OF YElM
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Yelm School District
ATTN: SUSAN CROY
PO BOX 476
YELM, WA 98597
360-458-1900
Sold to: 16755
EVERGREEN STATE BUILDERS LLC
56622
BUILDERS LLC EVERGREEN STATE
5516 75TH ST W #1
LAKEWOOD, WA 98499
# 5808 09 03/16/05
Reg #1 SalesPerson SUSAN
Item # 2900/MITIGATION
MITIGATION/CAPITAL PROJECTS
1@10,266.0010,266@0.
CK #9392 FOR YELM TERRA LOTS 4 ,49, 4,57
,60,65
SubTotal
10,266.00
Total Due
Check
10,266.00
10,266 00
----------
----------
Thank you.
PLEASE KEEP THIS RECEIPT!!!
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LOT 4~
EVER REEN STATE BUILDERS
YELM TERRA
15826 104thAVENUE SOUTHEAST
YELMt WA
SITE PLAN APPROVAL
APPIlOY(D AS mstJftm
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NORT~
(;) 2004 C^SCADE R[C::;IDENTlAL DESIGN, INC
SCALE I' = 3lZ>'
TIllS ORAWING ,'0 llASF.!:l ON CUF.IIT-PROV'IlEO 'IIFORIol.l.TIOII RtP tsEHTtll TO BE ACCuRATE
AND REUA91.E. ANY DISCREPANC'ES BETWEr.N THIS DRAWING AN THF. ACTUAL SlIT CQNDITtONS
ARI; Tilt SOU; RES~ON:SIBllITt Of THE CLIENT.
Project Address/60S Z~ Q 'Y ~"'e ~. Parcel #" 0
Subdivision: Velh1 7efrPL Lot#: .~7 Zoning; .&lAtg i-t .-{Mrtllj
~ew Construction U Re-Modell Re-Roof I Addition U Home Occu~e" d
U Plumbing U Mechanical U Mobile I Manufactured Home Placement - a J ~ I ve
Project ~Scope ofWork:~ ~ I~ -F@y'lt 1.3 I!t. &tduJ-ICL ( MAR 1 0 Z005
Project value:$ 2 Z Y . 7~
Building Area (sq. ft) 1stFloortC~~ 2ndAoor/Z'-l:..Garage P??::.. Deck /b"0
Basement Carport Patio
# ~ # Bathrooms..3 Heati~ER or ELEClRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
ARCHllECTJENGIN
ADDRESS JJ Z. ..Q>
CITY7ZlClJrfla
ICENSE #
EMAll
TELEPHONE
BUILDING OWNER NAME:
ADDRESS
CITY
GENERAL. CONTRACTOR \~a.s t.rWt-V TELEPHONE
ADDRESS EMAlL
CITY STATE ZIP FAX
CONTRACTORS LICENSE # el.4 EXP DA CITY LICENSE #
PLUMBING ~TOR---i
ADDRESS 1818 ~ P'
..-,-..
CITY fa STATEuhl
CONTRACTORS LICENSE #
~.,'\.lAA ~ TElEPHONE~) ..5::"37 l?9't) CJ
EMAlL
ZIP 7" {] yy- " FAX 2 <:~ ~ -q~6c:;;
EXP DATE CITY lICENSE #
MECHANiCAl CONTRACTOR
ADDRESS
CITY STATE
CONTRACTORS LICENSE #
ZIP
TElEPHONE
EMAlL
FAX
EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools. if applicable.
I hereby certify 1hal1he abowlnfonnatlon is cCll19d and that the cons1rUction on. and the occupancy and the use of the
abo_ dascrIbed pIOperty wm be In accordance willi the laws. rules and regulations of the State of Washington and the
City of YeIm.
/~ ~- :?/~ 01)
Applicant's Signatunj - Date
Owner I Contnctor~s A9.!iiJ Contractor's Agent (Please ciide one.)
AID 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 Box 47S
Yelm. WA S8liSl
(360) 458-3835
(3GO) 458-3144 FAX
WlA1II1.ci.yelm.wG.us