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CITY OF YELM - BUILDING DEPARTMENT
RESIDENTIAL CERTIFICATE OF OCCUPANCY
Building Address 9928 Greenleaf Loop
Owner Name Yelm Property Development
Owner Address 16422 Middle Rd. SE
Yelm. WA 98597
Building Permit Number BLD-04-0220- YL Plan Number 1557
Remarks
Areas Inspected _ All Code Required
Special Conditions None
Building Official Gary Carlson Date. May 31.2005
This structure is in compliance with the International Residential Code (Chapter
51-51 WAC) as adopted by the Washington State Building Code Council pursuant
to Chapters 19.27 and 70 92 RCW, effective July 1, 2004
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FROM YELM SEWER DEPT
FRX NO 360-458-B166
Ma~ 27 2005 01 36PM P1
FAX TRANS~MISSION
RECr:nJED
MAY 2 7 2005
CITY OF YELJV!
P.O. BOX 479 - 931 NP ROAD NE
YELM, W A 98597
360-458-841 ]
AX 360-458...8166
DATE: 5-.;2-:?- -05"
FAX#: 4-7"25' - Lf3 4 '?{
PAGES: ( , including this
Cover sheet
From: 0\lN\ \:).
Subject: Lp.f- '-II '/dVII P~e..:' '-, 5.eI.0e.r >rJ~
Cf 9 ~8" Grue.nI~4 Lp- ~~ (
COMMENTS:
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** If you do not receive all caples or any copy is n)t legible, please call (360) 458-8411
as Soon as possible.
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PROJECT
CITY OF YELM INSPECTION LOG
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WALL
o 6"
% 8"
o other
9
Date
Comments
o Other
o PYA
SHEET ROCK/SHEAR WALL NAIL
OTHER
Comments
o C of 0
o CIvIl Fmal 0 Landscape Fmal
o SIte Dramage 0 s;a-e~k
)).,{jJlo~ I'
, I
PERMIT NUMBER
ADDRESS
SET BACKS Date FOOTING
Front "2--1) 0 12"
Rear ' tJ() ~'
SIde/Flankmg IV 0 other
SIde rJ 0 reqUired vents
FOOTING REBAR V' Date*WALLREBAR
Comments
COMBINED FRAME/ EXTERIOR SHEAR WALL INSPECTION
Hold downs 0 Shear NailIng 0
Frame 0 Gas/Propane 0
Plumbmg 0 Mechamcal 0
INSULATION
o Gas
o Foam and Seal
o Electnc
o Vapor barner
Comments
Comments
FINAL
I' Sewer Fmal
7 Address
'% Electncal
P InsulatIOn
Comments
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-04-0220-YL
Issue Date 01/06/2005
(Work must be started within 180 days)
Receipt No
34422
Applicant:
Name Yelm Property Development
Phone.
458-0544
Address. 16422 Middle Road SE
City' Yelm
State WA Zip 98597
Property Information
Site Address. 9928 Greenleaf Loop SE
Assessor Parcel No 84070004100
Subdivision. Willow Glen Phase II
Lot: 41
Contractor Information
Name Applicant
Contact:
Phone
Contractor License No YELMPDL00302
City'
Expires 02/22/0553
State
Zip
Address
Business License.
Project Information
Project: Willow Glen Phase II
Description of Work: 1557 SFR, lot 41
Sq. Ft. per floor' (1 st) 784 (2nd) 773 (3rd) 0 Garage 453 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 1,062.74 99375 6899 5 6000 12.3200 $1,000
Building Plan Review 449 00 000 000 o 0000 o 0000
Mechanical Permit 78.25 000 000 o 0000 o 0000
Plumbing Permit 104 00 2000 8400 7 0000 12.0000 Fixture
Sewer Inspection 145 00 14500 0.00 o 0000 o 0000 ERU
Water ERU 1 500 00 000 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 o 0000 o 0000
State Building Fee 450 450 000 o 0000 o 0000
Sewer ERU (LID) 2,694 00 000 2,694 00 2,694 0000 1 0000 ERU
TOTAL FEES $7,184.99
Applicant's Affadavit:
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
OFFICIAL USE ONLY
# Sets of Prints
Signature
/) ,//t. B~c"'-'1
Date
Ij6/'-'S
Final Inspection'
Dole ~
By' ( .
Firm
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PAt:)
5 LfLj d- d-
City of Yelm JAN 0 6 PAid
Community Development Department
Permit Fees Schedule
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name Yelm Property Development
Address 16422 Middle Road SE
Project Information
Project: Willow Glen Phase II
Description of Work: 1557 SFR, lot 41
Site Address 9928 Greenleaf Loop 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 805 412-343-80-00
Water ERU 712 401-343-80-01
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 (LID) 802 412-343-50-01
TOTAL FEES
Permit No BLD-04-0220-YL
ClTY OF YELM
City' Yelm
Phone.
State: WA Zip 98597
458-0544
Assessor Parcel No 84070004100
Item Fee Base Amt
1,062.74 993.75
449.00 000
78.25 0.00
10400 2000
145.00 14500
1,500 00 000
300 00 300 00
4000 4000
757 50 000
50.00 5000
450 450
2,694 00 000
$7,184.99
68.99
Unit Rate No Units Unit Desc
Unit Fee
000
5.6000 12.3200 $1,000
o 0000 0 0000
0.0000 00000
000
84 00 7 0000
0.00 0 0000
1 500 00 1,5000000
000 o 0000
000 o 0000
757 50 7500000
000 o 0000
000 o 0000
2,694 00 2,694 0000
12.0000 Fixture
o 0000 ERU
1 0000 ERU
o 0000
o 0000
1 0100 Peak PM Trip
o 0000
0.0000
1 0000 ERU
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--~-~-
~Tlfl'~ CITY OF
,~y ~~I YELM
~ PO Box 479 'j4421
Yelm, WA 98597 RECEIPT No ~ '
.."YE!-"~_"," 360-458-8403
RECEIVEP
I ***SEVEN THOUSAND TWO HUNDRED NINETY SEVEN DOLLARS & 35 CENTS
RECEIVED FROM
YELM PROPERTY DEVELOPMENT
16422 MIDDLE RD SE
YELM. WA 98597
458-0544
SITE 9964 GREENLEAF LP SE
DATE REC NO
01/06/05 34421
AMOUNT
7.297.35 CHECK
REF N
604:
MISCELLANEOUS RECEIPT
GRETCHEN
BLD PER 1083.73. PLN REV 457.87. MECH 78.75. PLM PER 111. SEW INS 145.
WAT ERU 1500. WAT MET 300, CON DEP 90.TRAF 757.50. STAT BLD4.50. SEWERU 2j
~Tlfl'~ CITY OF
,~y ~~I YELM
I~ PO Box 479
Yelm WA 98597
I_..,;YE!-"~G"'N 360-458-8403
I
I RECEIVEp* * * SEVEN THOUSAND ONE HUNDRED EIGHTY FOUR DOLLARS & 99 CENTS
I RECEIVED FROM
I YELM PROPERTY DEVELOPMENT
I' 16422 MIDDLE RD SE
YELM. WA 98597
i 458-0544
i SITE 9928 GREENLEAF LP SE
l
RECEIPT No 34 4 22
DATE
01/06/05
REC NO
34422
AMOUNT
7.184.99 CHECK
REF ~JC
6042
MISCELLANEOUS RECEIPT
GRETCHEN
BLD PER 1062.74,PLN REV 449, MECH 78.25. PLM PER 104. SEW INS 145.
WAT ERU 1500.WAT MET 300,CON DEP 90.TRAF 757.50.S BLD 4.50.SEW ERU 2694.00
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Yelm School District
ATTN. SUSAN CROY
PO BOX 476
YELM, WA 98597
360-458-1900
Sold to: 16616
WILLOW GLEN 2
WILLOW
GLEN 2 WILLOW
16422 MIDDLE RD SE
YELM, WA 98597
~ 5652 09 01/06/05
Reg ~1 SalesPerson SUSAN
Item ~ 2900/MITIGATION
MITIGATION OR TVF ~
1 @ 3,290.00 3, 90.00
2 CK ~6041 FOR LOTS 40 NO 41 WILLOW GLEN
----------
SubTotal 3,290 00
Total Due
Check
3,290.00
3,290.00
----------
----------
Thank you.
PLEASE KEEP THIS RECEIPT!!!
't
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CITY OFYELM ecelve
RESIDENTIAl. BUILDING PERMIT APPLICATION FORM DEe 3 0 2004
Project Address: tq;(g GNe.h,J LoOi Sf PaiCel #'
Subdivision:Waltow Glenn ,.D:- Lot#:. ~/ Zoning; R..,.c.,.
~ew Cons'"uuction 0 Re-Modell Re-Roof / AddfJon 0 Home Occupation Sign
o Plumbing 0 Mechanical 0 Mobile / Manufactured Home Placement 0 Other
Project Description/Scope of Work: S~1r ~i 1t.1 ~
Project Value. $ 1"/' e...
Building Area (sq it) 1st Roor;J.J.!:[ 2nd Roor 7 7..J Garage Deck
Basement . Carport Patio
I
# Bedrooms2 /# Bathrooms ?-~'b Heating:~THER or ELECTRIC (Circle One)
he there any environmerrc.ally sensitive areas located on the parcel? ,.k If yes, a
completed environmental checklist must accompany permit application.
.8t1I1~IYINGUijWb1EEfW(ME: , LLC
ADDRESS -~~-rr::i 2;;::- M1 cfd It ~ S.
CITY STATE INti- ZIP 9~sq7 TELEPHONE
~B'GF.irrEGt.'tENGJNEEa F,Yle.. ~'IU- UCENSE #
ADDFfESS~/;i-;"= IE. - 4 ~ ~
CITY bf'1I'lt-I)I'e. STATEW^" ZIP"1f?~1 TELEPHONE .,)(,0 '1S-'- 0885"
.'.,"- _._~~-..-....-.-..:.- ..:.-' .'PDLLC
8J~.~g8A!tC..PJ~Ifl~gOB y .
ADDRESS ic#\'O-"Z- /lltacLd&.-. /l..J 5e
CITY yp/;wL STATE w* ZIP
CONTRACTOR'S UCENSE If VPDl,005()'L.
TELEPHONE 36e JeSb-'{JS'I'i
&18>'17 FAX dW ~6ro-O~-e,Lf
EXP DATE2/IJ,k'CITY UCENSE#fJLt'~OOU21
PLUMBING:CONTRAcT08 WYlie I<!~t'~ \ TELEPHONE 0'0 lH't- /f.:,J. '1
ADDRESS . 77I2~--'lo -.1- ~ se ~ - -
CITY Y~/p' ~ATE wI\- ZIP~? FAX dGo f:}H.I'3/
CON1RACTOR'S UCENSE If hJifrrc.( PeeS's p~ EX? DATE~ CITY LICENSE if
MECHANICAL CONTRACTOR ~i:4J;.l f.W~~ ~~iIll1 TELEPHONE
ADDRESS 3iiSlf> 71tNw"ltX DR E
CITY Ea.:hmvilj-t STATE wit I ZIP 'J6.5:lg FAX
CONTRACTOR'S LICENSE #/ tlo~JZtfc'j~? K. EXP DATE CITY LICENSE #
V' Copy of mitigation agreement with Yelm Community Schools, if applicable
I hereby certify that the above information is correct and that the construction on. and the occupancy and ,he use
of ihe acove describec propert'J will be in accordanc!! with tOg laws, rules and regulations ot the State of
Washing,on and ,he City of Yelm.
Dv-l'h- (J_~-u4 (..ll 30) by
Applicant's Signature Date ' /
Owner / Contractor I O',o'mer's Agent / Contractor's Agent (Please circle one.)
, .AIl permits are non-transferable and will expire if work authorized by such permit is not
Qo'tegun within 180 days of issuance, or if work is suspended or abandoned for a period of
180 days
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