BLD-05-0076
@J
I
~
....
z
w
:!:
....
0::
<t
a..
w
c
C>
z
C
...J
-
::>
m
I
:!:
...J
W
>-
LL.
o
>-
....
-
u
>-
u
z
<t
a..
::>
u
u
o
LL.
o
W
....
<t
u
LL.
-
....
0::
W
U
...J
<t
-
....
z
w
C
CJ)
W
0::
UJ
(f)
<ri
>
<(
("')
l.C'>
~ b
Q) I
:Q ~
:J ...,.
co ~
$("')<(
~~>
C/)Ol>
c("')-o
Q) x 0
Q) 0 0
'- CO :!:
.... . Q)
~q~
UJa..-l
co
N
0::
--
o
..-
(0
..-
.....
Q)
.0
E
:J
Z
C
..!ll
a..
-l
>-
cD
I'--
o
o
I
l.C'>
o
o
-l
CO
-0
Q)
.....
:J
Q)
0::
Q)
-0
o
o
<(
l.C'>
o
o
N
l.C'>
N
U;
:J
:J
<(
Qj
ro
o
Q)
C
o
Z
C
o
oo
-.::
III
o
<.9
.r:.
-...,.
o
..-
(0
It)
CXl
l.C'>
.....
Q)
.0
E
:J oo
oo Z C
oo oo .... -0 0
Q) oo E Q) E III
..... Q) ID U -0 'u
-0 E-o ..... Q) C :t:
-0 ID 0. 0
<( Ill-o a.. oo oo 0 0
en Z<( en ~ C en
C ..... ..... C ..... III .~
~ Q) ID III oo 'u
:Q C C :Q E III :Q
:!: :!: Q) Q)
:J :J ID ..... 0. :J
a:l 00 a:l 0:: <( C/) a:l
I
I
t@j
....
..... C
ID III
a.~
III .....
.c::J
~~
ID U
-oC...,.
O:JO
000
_ON
IllID -
~"'C~
CO>.
~O"S
'w en-'
ID.~ ~
0:: -0 ._
-==(3
~~~
o .....
.- ID Q)
rom -
C....s:
Ui(f)o
c50::
a; o,N
.c:C~
....:co
.c:ool'--
."!:: III -0
:!: s: C
ID III
UIDI'--
c:5N
.!!! >'m
c...o..-
E -0 oo
o ID .....
ua.$
coo.
.- -0 III
OOIll.c:
.- 0
~ ~ 0
:J _....
uO
:J<(
~~
oo ..-
:CU;>
1-..-
l.C'>
(\
"----/
c
c
CITY OF YELM INSPECTION LOG
PROJECT I~ '7\
PERMIT NUMBER 0 ~ - 0011..1
ADDRESS
l ~ b 5"&
ll.?\...\ ~ Av-L S~
.
SET BACKS Date:
Front ZV
Rear 2-~
Side'Flanking
Side 5"'
FOOTING
o 12"
o 16"
o other
o required \'ents
WALL
o 6"
o 8"
o other
Z\
'7
FOOTING REBAR
Date:
WALL REBAR
Date:
Comments
COMBINED FRAME/ EXTERIOR SHEAR WALL INSPECTION
Hold downs CJ ~.4 J-m;Shear Nailing 0
Frame J ~ ~b.~as/propane u ~
Plumbing p Mechanical CJ
Comments
~ ~o~m and Seal
~..-/
Comments. \
SHEET ROCK/SHEAR VALL NAIL
Comments ;JV ~16(
I~Sl'LA TION
o Electric
~ Vapor barrier
o Other
YPVA
OTHER
Comments
FINAL
/J Sewer Final .t Electrical
$ Address ~Insulation
comments~ ~~~Jp(
I I
o Civil Final 0 ;(andscape Final 0 C of 0
o Site Drainage '(f ~ide~
o
o
~....:..........~
~
..~
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No:
BLD-05-0076- YL
Issue Date: 03/16/2005
(Work must be started within 180 days)
Receipt No: 35903
"PPI!can~:
Name: Evergreen State Builders
Phone:
253-475-6622
Address: P.O. Box 39753
City: Lakewood
State: WA Zip 98499
P1QP~rty!J,forll1.0i!i9l!:
Site Address: 15856 104th Ave SE
Assessor Parcel No, 85840005400
Subdivision: Yelm Terra
Lot: 54
Contractor Information :
,...~~ ,.~ .._~ 'U~~,'''",.'.L~' , uu U~'_"W'O
Name: Evergreen State Builders
Contact: McCullem, Tom
Phone: 253-475-6622
Address: P.O. Box 197
City: Lakewood
State: WA Zip: 98499
Contractor License No: EVERGSB980PB
Expires: 10/02/06275
Business License: 1042.0
PrQjecHnfQrrT\atiQn:
Project: Yelm Terra
Description of Work: Plan 1610 R/2B , Lot 54
Sq. Ft. per floor: (1st) 1610
(2nd) 0
(3rd) 470
Garage 0
Basement 0
Heat Type (Electric, Gas, Other): GAS
Eees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
--------------------------- -------------
Building Permit 100-500k 1,090.90 993.75 97.15 5.6000 17,3490 $1,000
Building Plan Review 460.90 0.00 0.00 0.0000 0.0000
Mechanical Permit 71.75 0.00 0,00 0.0000 0,0000
Plumbing Permit 111.00 20,00 91.00 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 1,500.00 1,500.0000 1.0000 ERU
Water Meter (SFD) 300.00 300.00 0,00 0.0000 0.0000
Water Deposit 40.00 40.00 0,00 0.0000 0.0000
Traffic Facilities Charge 757.50 0.00 757.50 750.0000 1.0100 Peak PM Trip
Sewer Deposit 50.00 50.00 0.00 0.0000 0.0000
State Building Fee 4.50 4.50 0.00 0.0000 0.0000
Sewer ERU 5,417.00 0.00 5,417.00 5,417,0000 1.0000 ERU
TOTAL FEES: $9,948.55
"pplicOiI!.(~~~ffOid.avit:
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/ ~t' Date r-/~-.!!JS'
Firm ~S~
OFFICIAL USE ONLY
# Sets of Prints:
.
r~~~~~~~~~~~:~J~~O~~~~1;~~~~~~1~r
, ~~~~~!I (];TY OF
I ~ )ELM >.,~ .~ ~
I ~ FO P"x 47q ) ,r ~
/" ' Y81~,VV,~' 9:3597 RECEIPT No. ,-I ~ 9lJ 2
YEbM"". 360-458-3403
RECEIVED
****NINE THOUSAND NINE HUNDRED EIGHTEEN DOLLARS & 69 CENTS
RECEiVED FROM
DATE
REC. NO.
AMOU~JT
REF NO.
EVERGREEN STATE BUILDERS
P.O. BOX 39753
LAKEWOOD WA 98499
253-475-6622
BLD050074YL
03/16/05 35902
9,918.69 CHECK
9389
MISCELLANEOUS RECEIPT
JANINE
EVERGREEN STATE BUILDERS # BLD-05-0074-YL
o DO . .~,:.
:;..'-. .,..., """,, ..~- .-,-~,- _.-- ~= -"= -,-
.__ _.-_. n___ _._.'.___ _.__. _n ,. _. __ n.___ _._.
_c._,~ ;~t~1tt~\t\.:~~tiil1
THOUSAND NINE HUNDRED FORTY EIGHT DOLLARS & 55 CENTS
I
I
I
!
i
I
I
i
i
I
\
',--
RECEiVED FROM
DATE REC. NO,
AMOUNT
REF. NO
EVERGREEN STATE BULDERS
P.O. BOX 39753
LAKE WOOD WA 98499
253-475-6622
15856 104TH AVE SE LOT 54
03/16/05 35903
9,948.55 CHECK
9389
MISCELLANEOUS RECEIPT
JANINE
BLDER 1090.90,BLDPLNREV 460.90, MECH 71.75, PLUM 111, WTR ERU 1500, W MET300,
CONS DEP 90, TRAF 757.50, BLD FEE 4.50, SEW ERU 5417,
","'~";"E;::-'~=-""'_"'__-- ". 'c.-
o - 11 0
. .. a:;.
I' ~1;~~~-~;:~i-C{lr8i~~' .--- "-0_"__'
il (~ PO Bo, 479
I :... . Y,lm. WA 98597
I "YE.b.~,,_.. 360-458-8403
I RE<;:EiVED
I ***TEN THOUSAND TWO HUNDRED SIXTY SEVEN DOLLARS & 69 CENTS
I
I
I
I
I
I
\
'-------------
BLDPER1301.19,BLDPLNREV 549.75,MECH 84.75, PLUM 118, SEWINS 145, WTR ERU 1500
WTR MET 300, DONS DEP 90, TRAF 757.50, SEW ERU 5417,
RECEIPT No. 35904
RECEIVED FROM
DATE
REC. NO.
AMOUNT
REF. NO.
EVERGREEN STATE BUILDERS
3815 100TH SAT SW STE 2A
LAKEWOOD WA 98499
253-475-6622
15774 104TH AVE SE LOT 42
03/16/05
35904
10,267.69 CHECK
9389
MISCELLANEOUS RECEIPT
JANINE
... ....... '.. .. n"~^.
A~p!!c.Clnt:.
o
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Name: Evergreen State Builders
Address: P.O. Box 39753
P.!()j~c.!lnformation :
Project: Yelm Terra
Description of Work: Plan 1610 R12B~
Site Address: 15856104th Ave SE i'-..~
Fees:
Item
Building Permit 100-500k 032001-322-10-00
Acct Code
Building Plan Review 100001-345-83-00
Plumbing Permit
Mechanical Permit 032001-322-10-00
032001-322-10-00
Sewer Inspection
Water ERU 712401-343-80-01
805412-343-80-00
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:
City: Lakewood
o
Permit Fees Schedule
Phone:
Permit No: BLD-05-0076-YL
State: WA Zip 98499
253-475-6622
Assessor Parcel No. 85840005400
Item Fee Base Amt
1,090.90 993,75
460.90 0.00
71,75 0.00
111,00 20.00
145.00 0.00
1,500.00 0,00
300,00 300,00
40.00 40.00
757.50 0.00
50.00 50,00
4.50 4.50
5,417.00 0.00
$9,948.55
Unit Fee
Unit Rate No. Units Unit Desc
0,00
5.6000 17.3490 $1,000
0.0000 0.0000
91,00
7.0000
0,0000 0,0000
13.0000 Fixture
1,0000 ERU
1.0000 ERU
0.0000
0.0000
1.0100 Peak PM Trip
0,0000
0,0000
1.0000 ERU
PAID
MAR 1 6 2005
CITY OF YELM
97.15
0.00
145.00
145.0000
1,500.00 1,500.0000
0.00 0.0000
0,00 0.0000
757.50 750.0000
0.00 0.0000
0.00 0,0000
5,417,00 5,417,0000
o
o
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 @ 10,266.00 10,266,OOg
CK #9392 FOR YELM TERRA LOTS 42,4 ,54 57
,60,65
SubTotal
10,266.00
Total Due
Check
10,266.00
10,266.00
----------
----------
Thank you.
PLEASE KEEP THIS RECEIPT!!!
03/09/2005 13:45
2532843183
o
CASCADE RESIDENTIAL
o
LOT 54
REEN STATE BUILDERS
YELM TERRA
15856 l04thAVENUE SOUTHEAST
YELM, WA
EVER
SITE PLAN APPROVAL
] APPROVrO AS'P'[~[~:!O 10 Rr"sr AND R[~~~"I!
RrvlEwr" BY (CUM): ,--
.,----. ,"~
om,
---., _.
NOTES:
~
1?Q
PAGE 03
~
~(
-1A)
~~
Of
(0
0-1
~
O--v
<0
!>t'
~
J"~
o
It- 'P{.- "
-1 )oA <'/;r;- /
'-1' '\.. i(C' ) (
(,-A~ / ,
'i(C'''' ",
~ '"
/0 '" ",
~ ~" '"''
"'1 k '" '"
<: Jj>('<<
'"
OSITE PL N
.'; lC :r~'1
JV Lt.,'
~ ;; J.1l.L-.
I
@ 2004 CASCADE RESIDENTIAI_ DESICN, INC.
6CALE " ~ 30'
T~IS DRAWING I~ SASr.D ON CLIeNT-PROVIDED INFO~MAIIDN R,P E"'E'li.o TO DE ACCURATE
AND RF.I,IABLL ANY DISCR~~ANCI.S B~Twr."N nll~ DRAWING AN Tr<r. ACTUAL Silt CONDITIONS
ARC. THE SDI,E RE5fON~IBILlTY or THE ClIENI.
@
NORTI-I
Project Address: /..r;9' s-D/ CJ 9'~4AP6' ~ Parcel #: 0
Subdivision: Yef'wt --U/rPL Lot#:lo/' Zoning; ..&Ul.g 1# -tiRe~elved
~ew Construction U Re-Modell Re-Roof I Addition U Home Occupation ~R 1 0 2005
U Plumbing U Mechanical U Mobile I Manufactured Home Placement U Other
Project Des'ionlSCOpe ofWork:~ fj Ie -FaHl" 03 ~ &' duJ-, CL (
Project Value: ~ / .J ....~....s-O
.
Building Area (sq. ft) 1st Floor/b ~ 2nd Roor Garage ~7 0 Deck
Basement Carport Patio Z/ c:,
# BedroomsA # BathroomsL 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
ARCHITECTIENGINEE
ADDRESS JJ Z. ~
CITY72lC8Yt7a
GENERAl CONTRACTOR \~ as o--wur TELEPHONE
ADDRESS EMAll
CITY STATE ZIP FAX
CONTRACTORS LICENSE # eI4T~EXP DAT~CITY LICENSE #
TELEPHONE~)S-~7 8'9tJ C)
EMAll
FAX z<:":<;~-q?~
EXP DATE CITY LICENSE #
MECHANiCAl CONTRACTOR
ADDRESS
CITY STATE
CONTRACTOR'S LICENSE #
ZIP
TELEPHONE
EMAlL
FAX
EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable.
I hereby certify 1haIthe above information is comlCt and that the construction on. and the occupancy and the use of the
above de~ plOperty wW be In accordance with the taws, rules and regulations of the State of Washington and the
City of Yelm:'
/ ~~ --- j'-/CJ -C?S-
Applicant's Signature ~ Date
Owner I Contracto.r~ner's Agen 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 Box 479
Yelm, WA 98591
(360) 458-383S
(360) 458-3144 FAX
www.d.yelm.wo.uit