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20040189 ~@ ,@ll~~"-- Cli'( Of '(ELWI _ 8UILOING OEP P-RiWlENi RESIOENilP-L CERilfICP- iE Of ocCUP p-NC'( 6ui\ding f\ddress owner ~ame owner f\ddress ~ ~ ~~ ~'N~153 ~ ~ p\an Number 6ui\ding permit Number RemarKS ~ p..\\ Code ReQuired ~ Meas \nspected specia\ conditions ~one oate 6ui\ding Omciat . . l\ lole<oa\\ooal Resldeo\\al code (CMple! ,l\iS slroclore is io eO!llpllOoee :).'Il\ ~i: Ion 5\3le Boildin9 Code cooneil porsoanl 5~-5~ 'Nf\C) as adopted b'/ tn.;a dS'O ~2RC\N e<<ectNe Joly \.2004 to cnapters ~9.21 an I ' G. car\Son c PROJECT CITY OF YELM INSPECTION LOG ~r(P& y~~~ PERMIT NUMBER t) i.- 0/87 ADDRESS /5'751 q /(>1/ r:J.. 4' u S~ ~T BACKS Date ~.~ Front )j ~ :\-\ ~ ~~~lFlankmg \~'\ SIde 2..0 LfZJ f 5' FOOTING REBAR ~ate tv. Comments . AO''& IJ FOOTING D 12" ~6" D other D reqUlred vents WALL REBAR /7ytJ WALL D 6" ~" D other ;tj) , Date COMBINED FRAME/ EXTERIOR SHEAR WALL INSPECTION Hold downs D Shear Nmhng D Frame J::' ~I Gas/Propane 0 Plumbmg p 0( Mechamcal D c Comments INSULA TION Comments D Gas D Foam and Seal D Electnc D Vapor barner D Other D PYA SHEET ROCK/SHEAR WALL NAIL Comments OTHER F~L ;r;z Fmal ~ddress Comments Comments /Eleetneal ;} elVll Fmal 0 ~scape Fmal/c of 0 J(;U()1( SIte Dramage;O SIdewalk (', \J / FROM YELM SEWER DEPT FAX NO 360-458-El166 Apr 27 2005 09 08AM Pi FAX TRANSMISSION CITY OF YEL M P.O. BOX 479 - 93] NP ROAD NE I YELM) W A 98597 \J 360-458M8411 .. ~R \ /FAX 360-458-8166 &-7f /0 DATE: L/ -;r7~ 0 ":)- FAX#: . PAGES: !, including this Cover sheet From:)? ANO Y (Seck,)\:: r-2.~ Subject: HOLA S ~ F \ I\J~L / ul CL W"\ - 1 ') 8-CG(A COMMENTS. LoT cto) 1 ~-'61.31 DL1~1 Auf_ c~ t- J b'S- '5La~O. OD >fli!< If you do not receIve all copies or any copy is not legible, please call (360) 458R8411 as SOOn as possible ~ CIty ofYe1m - Buildmg Department CORRECTION NOTICE a ~ I have this day Inspected this structure and these premIses and have found the following vIolations of the CIty of Yelm and/or State laws governmg same 3) W ~$--rl? TqS AM. 5 ~ ~~~~ F'v::; ~ ^ f ~ q In~~ I-~ UJ :z~ Hp,tt-- I ~fJ~/~ b ~ .s 4p. -r;;t ~ S If} e <7 /-' l' ~ ~{J. /-v cLu. r-te--~ <94-f? ~~ {,Jvet:.. tv-u. <b S v-rL'r ~..11"- ^o-lA ;j, ~ ~ ~cJ- ~f\ ~ kA'r PERMIT NO. O~... ()t89 Wl-LP/.p o z--j 4;- ( l Wlv~ i:t; / s r HHK../ ;VeN t-' I L\) You are hereby notified that no more work shall be covered upon these premises ill the above violations are corrected. When corrections have been made, call for re-inspection at 458-84 DONOTREMOVETIDSTAG DATE ~i"( o o City ofYelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Permit No BLD-04-0189-YL Issue Date 11/23/2004 (Work must be started within 180 days) Receipt No 34116 Applicant: Name Evergreen State Builders Phone' 253-475-6622 Address. POBox 39753 City' Lakewood State W A Zip 98499 Propertylnformatiol1 Site Address 15813 104th Ave SE Assessor Parcel No 85840006600 Subdivision. Yelm Terra Lot: 66 Contractor Information Name Evergreen State Builders Contact: McCullem, Tom Phone. 253-475-6622 Address. POBox 197 City' Lakewood State' WA Zip Contractor License No EVERGSB980PB Expires 10/02/06275 Business License' Projecflhf6rmation Project: Yelm Terra Description of Work: Plan 1740B/2, Lot 66 Sq. Ft. per floor' (1 st) 854 (2nd) 952 (3rd) 0 Garage 418 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 1,14915 99375 155 40 5 6000 27 7500 $1,000 Building Plan Review 485.51 000 000 o 0000 o 0000 Mechanical Permit 78.75 000 000 o 0000 o 0000 Plumbing Permit 111 00 2000 91 00 7 0000 13 0000 Fixture Sewer ERU 5,269 00 000 5,269 00 5,2690000 1 0000 ERU Sewer Inspection 145 00 000 145 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 o 0000 o 0000 Water Deposit 4000 4000 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 TOTAL FEES $9,89041 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 applying as a contractor I futher certify that I am currently registered in the State of Washington. Signature /~,.- =._~ Date //- 27 b -y Firm ~ ,->'" /')', # Sets of Prints Finallnspectl~'on: O,t, Sf '-i n By' o o Permit Fees Schedule City ofYelm 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 1740B/2, Lot 66 Site Address 15813 104th Ave SE Fees Item Acct Code Building Permit 100-500k 032 001-322-10-00 Building Plan Review 100001-345-83-00 Mechanical Permit 032001-322-10-00 Plumbing Permit 032001-322-10-00 Sewer ERU 802 412-343-50-01 Sewer Inspection 805 412-343-80-00 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 TOTAL FEES Permit No BLD-04-0189-YL Phone 253-475-6622 City' Lakewood State. WA Zip 98499 Assessor Parcel No. 85840006600 Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc ------------- 1,14915 99375 155.40 5 6000 27 7500 $1,000 48551 000 000 o 0000 o 0000 7875 000 000 o 0000 o 0000 111 00 2000 9100 7 0000 13 0000 Fixture 5,269 00 000 5,26900 5,269 0000 1 0000 ERU 14500 000 14500 145 0000 1 0000 ERU 1,500 00 000 1,500 00 1,500 0000 1 0000 ERU 300 00 300 00 000 o 0000 o 0000 4000 4000 000 o 0000 o 0000 757 50 0.00 757 50 7500000 1 0100 Peak PM Trip 5000 5000 000 0.0000 o 0000 450 450 000 o 0000 o 0000 $9,89041 'f-J t:ll r-h4-u '== s c..l+O~c.... DlP M tn ~ol-\,..) ~€LEtPI _". >T>-,,", . eo. a \ e ,,"' &:I ::=;. "-'.! . .. =! :.., '~T;;"~~~<~~"~,"""",,,r;<'1'l'!it'~W" '\"l;:i"'1:;~ - Y . C> "~cr1;i"YJY'~~. .~~.t~~~~~~.;::tN;-~t;2~'.ttL~~~1 .....~ _ _ . . -..~{., . L ,t:"',,~..h!-JN'i~.c .~. ~~~~~.~ f\ - -- ~nil'-;,;fi CIT)' OF rl ~':t: YE'L1\ ,1 b1d-' L .1'," PC 5:::x ~~e ~ I~:- I ~ ~25S~ - - -,..,.....,. . YE_;'~~,,~ .jc......-...,~t' e4..;.... RECEIPT No .:: 4115 - -~~I\ Ci, r=0C \~r***NINE THOUSAND EIGHT HUNDRED NINETY DOLLARS & 41 CENTS =:::::1" =:= ~~:r,~ ~;,:.."TE r.=C UJ EVERGREEN STATE BUILDERS PO BOX 197 LAKEWOOD WA 98499 11/23/04 34116 9.890.41 CHECK PENDING / CELLANEOUS RECEIPT NA SITE: 15813 104TH AVE BLDPRHTI149.15. PLNREV485~~. PRMT78.75. PLHBPRHTlll. S/ERU5269. SINSP145 W/ERUI500. W/MTR300. W/DEP40. TRAF757.50. S/DEP50. STFEE4.50 ., --. - - -- " . ...- . '. '~~!srg!I''''''''-~-~~'~'''"O.'---'''''''-1''~'''--";_~'''r-';;'.;''~j-:<""11'1"P':~'~';;-''"~' l"I~~;\(:.t,j, l! -=.t:!C~ ffl .. I~j=:;:f {~.~['"';-,-!l_..' :t _ ~.;Jf;..~,.t:i~ ~.-~~~tti4:~ .i~~'.:';,!;~--r:"..~~g~'f;"i{. .~ _ ~~"._..~!I.lT_.. .. .='\J""'~,/>,,~O"""~ _ _ "_ :,-.W-jk;"'.",~".r",'\I..t" .,;1.1' F.._ ".:,.. ..,; l~~ ~ _.~ I!". t GOo:; ;, ::: -- :: -," !.--J -' ~.....' '" -I I. 1 "\ I F:EC E,!PT No ':1 Lf J. 1 { =::l_ -~: ': E-~,-:' t:'=,...~!\ ~I-l . -....ff.. tntEN THOUSAND FOUR HUNDRED THIRTEEN DOLLARS & 62 CENTS :-'::::J ~= =~=r. C:._T~ ;... 1\ _'_ EVERGREEN STATE BUILDERS PO BOX 39753 LAKEWOOD. WA 98499 SITE: 15850 104TH AVE SE 10T53 .~ 11/23/04 34117 10.413.62 CHECK PENDING MISCELLANEOUS RECEIPT DIANA BLDPRHT 1299.32. PLNREV844.55. HECHPRHT78.75. PLHBPRMTI25. S/ERU5269. SINSP145 W/ERU1500. W/MTR300. W/DEP40. TRAFF757.50. W/DEP50. STFEE4.50 ~~~~.ro;c'''~-",''''"'--""'-'' "+......... ..'- ,-, ~"~~(;~~,."~~~..,.~~ ..~~ -~-.2.--~:~.~-Io;-~~L-~.;..r:-~~("'~~"';,~t:.;Z~;t?~Tw::::rr'~."!'"{.i".r.'-..1.' ,~'~:r-itTP~.,. ~~.-'. '."',:!'f',~:,i<'<~-,,~!~~;t'~""'."'i''Yir,[~~ ,,~;;;~~. ..., '~71::, o"-'''~1I.' ~"\ ".:-;'-",u<'; I:i! _.-;;-:- ,- . ~;. .- _ h~}~-.5l~~t~t$;:t.~1i:"'i~A.~l;-;;'~g,,,,.:t;~.Cl ~~~;;'fT~v.-*~'-,~;-i,F,:,[.!",~;1;2~~~".~~'~ih.. T:'!"I'<I~...-:~~~-__~~~.. :.. --, ="" ~ .~~ . .~~FJ,\-o~.b-.mo..:=-~.-m"l~,_'__ _ ~~-4;'.>.:...!H:,,"~~lt1-t .li~''''-''''.~'~~-<J'~,,~,-'''',J~E~L-~ 16~,~:T'i CITY OF iE' /'~" ,.% I ~ Eli'i/l" r~~ (~'l ~. =- ~,:; - [2.-::Y:J ~::- ~ -E E<'. ., ~ -\. f- f:;EC EiPT r' ,-, ' dl 1 ,:; I p~i'-'=i /;:::- -*."*"TEN THOUSAND FORTY EIGHT DOLLARS & 73 CENTS =:.= ~::,=~=!., ~=~ -.! :... :\' - - EVERGREEN STATE PO BOX 197 LAKE WOOD WA SITE: 15838 BUILDERS 11/23/04 34118 10.048.73 CHECK PENDING 98499 104TH AVE SE LOT51 ~ MISCELLANEOUS RECEIPT DIANA BLDPRMTI090.90. PLNREV709.08. MECHPRMT71.75. PLHBPRHT111. S/ERU5269. S/INSP145 W/ERUI500. W/MTR300. W/DEP40. TRAFF757.50. S/DEP50. STFEE4.50 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 # 5606 10 12/02/04 Reg #1 SalesPerson SUSAN Item # 2900/MITIGATION MITIGATION OR TVF 1 @ 1, 711. 00 1 ,711 00 CK #5202 FOR LOT 51 OF YELM TERRA DEVELO PMENT Item # 2900/MITIGATION MITIGATION OR TVF 1 @ 1,711 00 1 ,711. 00 CK #5202 FOR LOT 53 OF YELM TERRA DEVELO PMENT Item # 2900/MITIGATION MITIGATION OR TVF 1 @ 1 ,711 .00 1, 711. 00 CK #5202 FOR LOT 55 FOR YELM TERRA DEVEL OPMENT Item # 2900/MITIGATION MITIGATION OR TVF 1 @ 1,711 00 1,711 00 CK #5202 FOR LOT 66 FOR YELM TERRA DEVEL OPMENT SubTotal 6,844 00 Total Due Check 6,844.00 6,844 00 ---------- ---------- Thank you PLEASE KEEP THIS RECEIPTI I I Applicant: o City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Address POBox 197 Name Evergreen State Builders City' Lakewood Phone State. WA Zip 98499 253-475-6622 Project Information. Project: Yelm Terra Description of Work: Plan 1740B/2, Lot 66 Site Address' 15813 104th Ave SE Fees Item Acct Code Item Fee 1,14915 Building Permit 100-500k 032001-322-10-00 485.51 Building Plan Review 100001-345-83-00 78.75 Plumbing Permit Mechanical Permit 032001-322-10-00 032 001-322-10-00 111 00 Sewer ERU Sewer Inspection Water ERU Water Meter (SFD) Water Deposit Traffic Facilities Charge Sewer Deposit State Building Fee 802412-343-50-01 5,26900 o PNElmit Fees Schedule NOV 2 3 Zurrrit No BLD-04.0189-YL CITY OF YELM 3'-1//~ Assessor Parcel No 85840006600 99375 155 40 Unit Rate No. Units Unit Desc Base Amt Unit Fee 000 000 56000 277500 $1 000 o 0000 0 0000 2000 7 0000 o 0000 0 0000 000 000 13 0000 Fixture 1 0000 ERU 1 0000 ERU 1 0000 ERU o 0000 o 0000 1 0100 Peak PM Trip o 0000 o 0000 805412-343-80-00 145 00 712 401-343-80-01 1,50000 712 401-343-80-01 300.00 740402-389-00-00 4000 420 120-344-85-00 757 50 742402-389-01-00 50.00 160 001-386-00-00 450 TOTAL FEES. $9,890.41 9100 000 5,26900 5,2690000 000 14500 145 0000 000 1,50000 1,5000000 300 00 000 o 0000 4000 000 o 0000 000 757 50 750 0000 5000 000 o 0000 4.50 000 o 0000 O~1V'~ f\<;' . {\- Lcl S 5U'i-e\ 'N\ '"\ ~fffl '.. CITY OF YELM RESIDENTIAL BUILDING PERMIT APPUCATION FORM Project Address L C+ Parcel #. Subdivision. '\~\W'\-T~(,i'1\ Lot#. (PC? Zoning; <;'\f\~\ ~\tv'\ .J1"New Construction 0 Re-Model/ Re-Roof / Addition 0 Home Occupation Sign o Plumbing 0 Mechanical 0 Mobile I Manufactured Home Placement 0 Other Project Description/Scope of Work. -:; 'f', <;;;) \ Project Value. ~i\",^ \1. u \ de...v\.-i' ~ ~.-l Building Area (sq. ft) 1st Floor ~&.{ Basement ~ - \. # Bedrooms3 # Bathrooms -z.:.1z... Heating ~THER or ELECTRIC (Circle One) Are there any environmentally sensitive areas located on the parcel? DO If yes, a completed environmental checklist must accompany permit application 2nd Floor f:(/~ Garage ~ Carport i- Patio '2..' 6 Deck BUILDING OWNER NAME "f'-\j ~teeY1 ~-\: tct-e. ~\ \d tf'~ L.. L. (, ADDRESS~815 JOtJ"t'? 'S-T $., Wi ~vtt€. 2.~ EMAIL I CITY L..l\itewoo~ STATE W It ZIP~ 8<-t ~ 1 TELEPHONE 2-53.-'175- 66 Z 2 ARCHITECT/ENG.INEER C~ t:le ~\"(~e LICENSE # ADDRESS I t>2~, :.2-6 ~ ('c t:EMA1L ")...53- 2.8'1- ~nD CITY (1Tc.~ f\- STATE w~ ZIP <"7f!r(a2 \.:fELEPHONE (~c.~e€I''1G. tJeknn.( GENERALc'ON'fRAc:foR $~e... fT~ Qwll'\eJ TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # iJe(( It.) qaOfbEXP DATE~ITY LICENSE # 4 TELEPHONE ~.5~-~31- '700 EMAIL ZIP7Prf'i 5" FAX 2-'5.3 -:536- CJ 606 EXP DATE CITY LICENSE # MECHANICAL CONTRACTOR ADDRESS CITY STATE CONTRACTOR'S LICENSE # ZIP TELEPHONE EMAIL FAX EXP DATE CITY LICENSE # Copy of mitigation agreement with Yelm Community Schools, if applicable I hereby certify that the above information is correct and that the construction on, and the-occupancy and the use of the above described pro pert will be in accordance with the laws, rules and regulations of the State of Washington and the City ofYelm. ~ }~~~~ plica 'Signature \ Date Owner I Contractor ~e~s Ag~Contractor'S Agent (Please circle one,) All permits are non-transferable and will expire if work authorized by such permit is not begun within 180 days of issuance, or if work is suspended or abandoned for a period of 180 days 105 Yelm Avenue West PO Box 479 Yelm, WA 9859'1 (360) 458-3835 (3GO) 458-3144 FAX llilliw.ci.yelm.wa.us nl1al~mB<; l2::'4$ 253"Q43163 .U ''''''''.'''''~;~~~;~;~:::';::::;;':;-''::;;;;;;P''':;';~;;':'~''';:~~'';\:I!1-''''"',....,.....,,""'.'''!''''''''''"\''''''' ""U _ '"' _t+._../"4 ...1;'" ",';,<::''7f.I~,~~~',,?l>>''~~''l'~,d1':~~'''';'~'':.M' LOT6'~ ,EVERGREEN STA'fE. 'BUILDEItS ~T i\..JI' 'T' 'r:'Dn."n .,: J..~J:.uY;.L' .. ~ n.'.laM WA.: , .. ... t " , W^,,] -lrJ- ~-; - u -- - -- --- - - -~ - - ~ - - -~- j ~,~.~~~~.......~~~. srQRt.lUW t, ,. ..: .... V" . . . 'I I :PRIV.!.Mr:E'Ro;~rf ! " -: SITE. PLAN, APPROVAl ' ....."''V><<&l/F.>l).ltH . iM!::~~iill; . !f\l(Xl',H"Q:lJl'!nl ..", ..:~t1 ~:S;llEPLA r< APP'Rp;. 'C rf.",rr=.'.~, ~' 'J Ik.. ..J ~?~=-,.~. e 2~O!~ ~ASCA.pt RES~OE~FnA m:SH~NiNCi" tIJiblll1.' A~. r~.n <ll.~A~C(l.'\lH:.ifu.'~m..9'vil1cD !!,,~~w.ticl<' "iwlt.~tHffll 'l'O,Qt' Ail. C~~A It "0, ~W~.t. lh,' Q1lIC.~"~~.I'a /ltTlI'((/I\'lilJa-,l.'II11l4 '~TH; .a~' lite ~111.\hl!I .u( ....!<Oc:f ~ 11' r>lf, ~..r,.' " 'Coo ' . I .. .. '$CAIioIi .I' ~ 3(?j' . - .~ " 1'/10/ ;?OJ41.2;1l,'-"PM;I:!I60 "_,~,_",__,_,,,'N"'_,""__ ~._,.<;~_.___._.,_.... ._-,0,.... --,,.....,,.--..-. ,.,.--. -- ._..,~""..- o o Evergreen State Builders LLC (license # EVERGSB980PB) 5700 _100"1 Street S.W , Suite 630, Box 197, lakewood, WA 98499 253-475--6622 (Fax 253-475-6127) DESCRIPTION OF MATERIALS for YELMTERRA 8' ceilings on first floor Siding: 8" pre-pnmed James HardIe lap siding on front, James Hardie single wall sidmg sides and back; James Hardie shakes or shake panels as accents front elevatmn per plan. Roofing: Architectural Composition roof. Windows: Vinyl wmdows to code and as per plan. Driveway: Broom finish. Patio/Walkways: Broom finish... Cabinets: Oak cabmets, flush panel. Doors: Embossed packa e. Exterior: Insulated steel, 0 fiberglass. Millwork: Embossed package. Window Wrap: Stool and Apron ~nlY Plumbing: I Kitchen Sink: 33x22, 3~hole, double-sink. Stainless with chrome delta faucet. La.vatory: ' I . Powder R~. white WIth Delta chrome faucet. e Hall Bath. Kilgore white sink With Delta chrome faucet. & Master"B;th: ~2) 20x] 7 white with Delta chrome faucets. . Tub V a1ve, .~aster bath. Delta chrome or eqUlvalent. . Tub/Shower alve, Main bath: Delta tub and shower valve. . Shower Valv , Ma_ster: Delta or equivalent. o Toilets. whitt, per plan. " Bath endosll1res: Hot Water Tank: Hosebib: Hardware: Bath hardware: Flooring: Countertops: Painting: Appliances: Wiring: o o Page one of two Master bath: Clear gla."ls door on separate shower with chrome tom. Tubs: Fiberglass white. Gas 50 gallon. Two per plan. Locks interior:, Chrome Locks exterior: Chrome Towel bars. Chrome Paper holders: Chrome Carpet: Dining room, living room, stairs, bedrooms, closets, 6 lb., 1/2" rebond pad. Vinyl: Utihty room, han bath and Entry Laminate: Whole house Exterior Trim. Vi1hite or color from approved lIst. Exterior Body:. Hat solid body paint from approved list. Front Door~ Enamel, white or accent color from approved lIst. Interior Walls: Drywall sealer coat, then one coat flat latex. Kitchen and batt@oms; Low sheen enamel. Range/Oven. Whirlpool wlute. Dishwasher: Whirlpool Self Clean, White. DISposal: 1/2 HP Icemaker: RefrIgerator space plumbed for icemaker Microwave. Whirlpool whIte Phone (2) cabl\;: (2) ]lIage two of two