BLD-05-0262
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Crr'! 01' '!E\.\'J\ - 6UI\.OING OEPARi\'J\ENi
RESIOENilA\. CERill'lCA iE 01' OCCUP ANC'!
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owner J\ddress
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special conditions
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to Chapters ~ 9 an '
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FAX#: '(. '1 ?'~- tf3L/'iJ
FROM YEU1 SEWER DEPT
FAX NO. 360-458-8166
Jan 11 2006 12 25PM Pi
FAX TRANSMISSION
CITY OF YELM
P.O. BOX 479 - 931 NP ROAD NE
YELM, W A 98597
360-458-8411
FAX 360-458-8166
DATE'
{-(I-D5
PAGES: I , including this
Cover sheet
From'IIM-- 'Dol7
Subject: ~€Y >y-Jf.eyt.{ F1~4t---~
COMMENTS.
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U If you do nol receIve all copies or any copy IS not legible, please call (160) 458-R41 J
a~ soon as pos~lhle.
CITY OF YEL!\.11NSPECTION LOG
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0262-YL
Issue Date 08/26/2005
(Work must be started within 180 days)
Receipt No
38099
Applicant:
Name: Comfort Homes
Phone:
360-486-0161
Address. 8306 Quinalt Dr NE
City' Lacey
State: WA Zip 98516
Property Information:
Site Address. 15408 104th Ave SE
Assessor Parcel No. 62320001300
Subdivision. Mill Pond
Lot: 13
Contractor Information:
Name: Comfort Homes
Contact: Bayless, Greg
Phone: 360-486-0161
Address 8306 Quinalt Dr NE
City' Lacey
State. WA Zip' 98516
Contractor License No. KERZIHL970M3
Expires 07/06/05187
Business License. 05-000730.0
Project ~nJormation.
Project: Mill Pond
Description of Work: Plan 2211/2A Lot 13
Sq. Ft. per floor' (1st) 1071 (2nd) 1140 (3rd) 0 Garage 434 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 1,299 34 993.75 305.59 5.6000 54.5700 $1,000
Building Plan Review 548.97 0.00 000 0.0000 0.0000
Mechanical Permit 8475 0.00 000 o 0000 o 0000
Plumbing Permit 125 00 20.00 105 00 7 0000 15.0000 Fixture
Sewer Inspection 14500 000 14500 145.0000 1 0000 ERU
Water ERU 1 500 00 000 1 500 00 1 500 0000 1 0000 ERU
Water Meter (SFD) 300.00 300 00 0.00 o 0000 o 0000
Water Deposit 40.00 4000 000 o 0000 0.0000
Traffic Facilities Charge 757.50 000 757.50 750 0000 1 0100 Peak PM Trip
Sewer Deposit 50.00 5000 0.00 o 0000 o 0000
State Building Fee 4.50 450 0.00 0.0000 o 0000
Sewer ERU (LID) 2,76900 000 2,76900 2,7690000 1 0000 ERU
TOTAL FEES $7,624.06
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 Sta e of Wa hington.
# Sets of Prints.
Firm
Date
Final Inspection:
Date: /- I ~'"'o ("
By' dl'lV J
Signature
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Permit Fees Schedule
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name. Comfort Homes
Address. 8306 Quinalt Dr NE
Project Information:
Project: Mill Pond
Description of Work: Plan 2211/2A Lot 13
Site Address. 15408 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 715401-343-80-02
Water Meter (SFD) 712401-343-80-01
Water Deposit 740402-389-00-00
Traffic Facilities Charge 420120-345-85-00
Sewer Deposit 742402-389-01-00
State Building Fee 160001-386-00-00
Sewer ERU (LID) 802412-343-50-01
TOTAL FEES
Permit No BLD-05-0262-YL
Phone:
360-486-0161
City' Lacey
State. WA Zip 98516
Assessor Parcel No. 62320001300
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
-------------
1,29934 993 75 305 59 5.6000 54.5700 $1,000
548.97 000 000 o 0000 o 0000
8475 000 000 o 0000 o 0000
125.00 2000 105.00 7 0000 15 0000 Fixture
145.00 000 14500 145.0000 1 0000 ERU
1,50000 000 1,50000 1 500 0000 1 0000 ERU
300 00 300 00 000 0.0000 o 0000
4000 4000 000 o 0000 0.0000
757.50 000 757 50 750 0000 1 0100 Peak PM Trip
5000 5000 000 0.0000 0.0000
450 4.50 000 0.0000 o 0000
2,76900 000 2,769.00 2,7690000 1 0000 ERU
$7,624.06
RECEIPT No 38099
RECEIVED
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RECEiVED FROM
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YELM COMMUNITY SCHOOLS
. LOeAL RECEIPT DA1E~_d5---.fAd
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COMFORT HOMES, L.L.C
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LOT 13
COMFORT HOMES
MILL POND
15408 104th WAY SOUTHEAST
YELM, WA
55.00'
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7'-6 OO'~D-
40'
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10' UTIL. ESMT
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LOT INFO.
LOT AREA == 4950 SO.IT
BUILDING COVERAGE == 1849 1 SO.IT
PAVEMENT COVERAGE == 360 SO.IT
TOTAL COVERAGE == 2209 1 SO.IT
, ~ OR446%
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L,~'/'
104th WAY SE
G-I-
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~~ SITE FLAN
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@ 20ClS r::ASCADE RESIDENTIAI_ DESIGN, INC
THIS DRAWING IS BASED ON CLIENT-PROVIDED INFORMATION REPRESENTED TO BE ACCURATE
AND RELIABLE. ANY DISCREPANCIES BETWEEN THIS DRAWING AND THE ACTUAL SITE CONDITIONS
ARE THE SOLE RESPONSIBILITY or THE CLIENT
~
NORT~
SCALE l' = 2rZl'
(]) CITY OF YELM
RE~)~NTIAL BUilDING PERMIT APPLICA Y-) FORM
Project Address./S"IQ AJ.!ti~<. .$~ Parcel #. i>>2.)--Z "DO I~ 0
~ ~ Subdivision. n~ \ \P.,,~--,,- Lot #'. J ~ Zoning;
Pfl..~1'( ~ew Construction L! Re-Modell Re-Roof / Addition LJ Home Occupation Sign
'rvPlumbing \l~eChanjcal LJ Mobile I Manufactured Home Place~ent 1.1 Other
Project DescriPti~/~cope of Work: ~ 51~ ~,~ ~-57ZJtV(
22.11 PUl-N
-'P~
(I~
4ttc . /1/
~ $" ~()
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"r5)'lY
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Project Value _-
Building Area (sqft) 1 sl Floor -1,QJJ 2nd Floor U'10 Garage It J~ Deck -
Basement_=-___Carport_ - _Patio..z...i~_
# Bedrooms.!:t- # BathroomsPt.-. Heating~THER or ElECTRJC (Circle One)
Are there any environmentally sensitive areas located on the parcel? _JL9-- If yes, a
completed environmental checklist must accompany permit application
BUILDING OWNER NAMff._.'_Ui~~TMWIt-~ -....--..-..--..--.- -'-.._.-_._~--.-
ADDRESS ~ '?Olo Q ~1l\4\'t.:(' ~ (II IE. EMAIL 3'\ ~ @ ~~~-z,iflA~(!,5. Ul~
CITY kAv~Y .ST ATE \Nt\--:: ZIP 9"&S'lh TELEPHONE (3(,6) ~ $9 - Ol:bl
ARCHiTECT/ENGINEER 0A'Sc.M>t."' ~~~IO~I1K --CiCENSE# ---......--.-----..--..,-
ADDRESS lOI-- SouTI1 2.-,,1"'" s-rn6tr EMAIL ~r\'\U@ ~~~P.,o"",
CITY ~~A- STATE~. ..ZIP . 'i~ 402 ""!:E~~PHONEL?_:e.21:~"(-:31~
UGENERAl CONTRACTOR. LoVlAfo-rtr !-i<lMISS - TEiiPHONE l~b6) lf~4-()}&1 '-'- J-
ADDRESS ~ :,c~ ~4,. I ~ -,?~N. /3... EMAIL.31 \Me!.' ~ t<'Z1 rf ~C~ , (,0\1\'\
CITY l-A<.hY STATE_IN\!\- ZIP "I8S16 FAX . bO .'-4S1 - 'B'
CONTR,:\ClOR'S ,LICENSE # KtR"4-1IH..'174l'Jt3EXP DATEI:~ rry LICENSE # {;; 3 J ..'
II- JVl3 S -
I PLUMBING CONTRAClORA:L.-PWl'lfllll1, _TELEPHONE -~~~
ADDRESS 2"117 IO~.n". or s. EMAIL; DD6CI<(~ 14:>.,. ~.W"'"
CITY_~'O STATE. ~. ZIP 9~'1~LIAX It.-5~) .S-~~-b801 :
CO~~<?I2.B:~~~~",,~S p~~ 'P~~~XP DA TE~fTY LICENSE # ..
MECHANICAL CONTRACTORIZCiIi';;;wii7B1ft;l11~TELEPH'ONE ftrS3)- 5'"37 -o~----
ADDRESS~~f03 \\b~ .sT. .f., EMAIL _kL-rv... /3"a.cs @. AtlL. ~"
CITY ~\IIIV!!: STATE~Z'P ...3i\'t~~ .FAX ~(~ S'"~<j-~B'~{
CONTRACTOR'S LICENSE # KLl~IIi\~HO"2-1 (3 r: EXP DA TE.1Ji;.... I' LICENSE #"
------
~-_. '---' ~......
_ Copy of mitigation agreement with Yelm Community Schools, if applicable.
I hBreby certify that the abo\>l'e informatlol1 .ts correct and that the construction on, and the oceupaney and the lISfl of the
above described pm~rty will be in acc(,)rdance with the lawl>, rule$ and rngulatlons of the State (If Washington and tile
CltyofV.'m. ~
Applicanfs SI atur. . Da"'~-+v4 0,,-
OWner I Contrsof I Owner's Agent I Contractor's Agent {Please circle one,}
All permits are nOI"ll~transferable and will expire if work authorized by sueh permit is not begun
within 180 days of iS$uance, or if work is suspended or ~bandQned for a period of 1BO days
lOt; Yelm. Av.emt;! WeRt
PO &x 479
Yelm, WA .98597
(360) 458...~8JI)
(.160) 458-..9144 "'''AX
www.ci.yelm.w(J. U,(J
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