BLD-05-0247
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CITY OF YELM - BUILDING DEPARTMENT
RESIDENTIAL CERTIFICATE OF OCCUPANCY
Building Address
15839 Yelm Terra Way SE
Owner Name
Owner Address
Everqreen State Builders
P.O. Box 39753
Lakewood WA. 98499
Building Permit Number
BLD-05-024 7 - YL
Plan Number
Plan 1740B/3 Lot 4
Remarks
Areas Inspected
All Code required
Special Conditions
Building Official
G. Carlson
Date
February 14, 2006
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 1927 and 7092 RCW, effective July 1, 2004
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FROM YELM SEWER DEPT
FAX NO 360-458-8166
Feb. 10 2006 11 13AM Pi
FAX TRANSMISSION
~'K~~
CITY OF YELM
P.O. BOX 479 - 931 NP ROAD NE
YELM, W A 98597
360-458-8411
FAX 360-458-8166
DATE: d-.-10 - 01.0
FAX#:
PAGES:) ; including this
Cover sheet
From: Qf'lA)OY
Subject: H 0 U\ S E" I=' \ JJ A L ! '1' E L,^" It; 1L~
COMMENTS: L 6\" L~ \ 5<!'3 '1 'f6LVn 115(L(U) wAY s. c;
65-5040 00
*"" If you do not \'cceive all copies or any copy IS not legible. please call (360) 458-8411
as soon as possible.
CITY OF YELt\1INSPECTION LOG
C PROJECT ~/.r) !7 tf{) /3 B L-o t '-/
PER..".llT NU!\1BER 0 <) - Od cf7
-\DDRESS I 52'~7 fi~ ,~~C( dkj S'c
SET BACI\S D:lle FOOn~G WALL
F rant ?-LJ :.J 1 T CJ 6"
~ Rear I/I? _ 0 16"' 0 S"
w)) Side Fbrlmg.) ~ other 0 other
It''''\\4. SIde 'I 8 requIred \ ents
q FOOTl'G REB\R ~ Da,,<.co5' II' \LL REB\R I3i ;YoOle 2". y
Corn!T:e!:t~
CO\lBI;\ED FRA\lE/ E\. TERIOR SHEAR \\ .\LL l\SPfCTIO"\
" --J. ' J ',12 .,
Hold downs ,Sj ,z'/- Shear :--lollIng ~ ?lJ!.
Frarne 'SJ TJJ G3.S 'Propane J ~_
Plur.Jbmg '~ ri! J} \1ech:mlc3l ~ /?i!..1l
C Comments
I'\Sl L.\TIO",
''1 G~s
~ F03m and Seal
J Electric
'~ \';:;porr.3rTler
" Other
- P\'-\
Comments
SHEET ROCK/SHEAR \\ .\LL \ -\IL
Comments
OTHER
Comments
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~ Se\\ er Fnal
:J ~djress
n Electrlc31
1] Insubtlon
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Comments
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
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Permit No
BLD-05-0247 - YL
Issue Date 08/10/2005
(Work must be started within 180 days)
3
Receipt No )17953
Applicant:
Name. Evergreen State Builders
Phone:
253.475.6622
Address. 3815 100th St. SW, Ste 2A
City' Lakewood
State: WA Zip 98499
Property Information:
Site Address. 15839 Yelm Terra Way SE
Assessor Parcel No. 85840000400
Subdivision. Yelm Terra
Lot: 4
Contractor Information
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. 10/02106275
Business License:
Proje<:t Information.
Project: Yelm Terra
Description of Work: Plan 17408/3, Lot 4
Sq. Ft. per floor' (1st) 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 993.75 155 40 5.6000 27 7500 $1,000
Building Plan Review 485.51 000 000 0.0000 0.0000
Mechanical Permit 7875 000 0.00 o 0000 0.0000
Plumbing Permit 111 00 20.00 9100 7 0000 13.0000 Fixture
Sewer Inspection 145.00 000 145.00 145 0000 1 0000 ERU
Water ERU 1,50000 000 1,500.00 1,5000000 1 0000 ERU
Water Meter (SFD) 300 00 300.00 000 0.0000 0.0000
Water Deposit 4000 4000 0.00 o 0000 o 0000
Traffic Facilities Charge 757 50 0.00 757 50 750 0000 1 0100 Peak PM Trip
Sewer Deposit 5000 5000 0.00 0.0000 o 0000
State Building Fee 450 4.50 0.00 o 0000 0.0000
Sewer ERU 5,41700 000 5,41700 5,417 0000 1 0000 ERU
TOTAL FEES. $10,038.41
J\Ppljc: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 /' W- Date ~-/e1-t!f1r
Firm 4FslI'S
# Sets of Prints:
Final Inspection:
Date:
By'
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:J CITY OF
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~ PO Box 479
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RECEIPT No 37952
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PO Box 479
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360-458-8403
RECEIPT No 37954
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Applicant:
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Name. Evergreen State Builders
Address. 3815 100th St. SW, Ste 2A
Project Information:
Project: Yelm Terra
Description of Work: Plan 1740B/3. Lot 4
Site Address. 15839 Yelm Terra Way SE
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
Sewer Inspection
032001-322-10-00
805 412-343-80-00
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 802412-343-50-01
TOTAL FEES
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PAID
AUG 1 0 Z005
CITY OF YELM
City' Lakewood
Permit Fees Schedule
Permit No BLD-05-0247-YL
31q Lj )
Phone.
State. WA Zip 98499
253.475.6622
Assessor Parcel No. 85840000400
Item Fee Base Amt
1,14915 993.75
485.51 0.00
78.75 0.00
111 00 20.00
14500 000
1,50000 000
300.00 300 00
40.00 4000
757.50 0.00
5000 50.00
4.50 4.50
5,41700 0.00
$10,038.41
Unit Fee
155 40
000
000
9100
145.00
Unit Rate No. Units Unit Desc
5.6000 27 7500 $1,000
0.0000 0 0000
7 0000
0.0000 0 0000
145.0000
1,500 00 1,500.0000
000 0.0000
000 o 0000
757 50 750 0000
0.00 0.0000
0.00 0.0000
5,41700 5,417 0000
13.0000 Fixture
1 0000 ERU
1 0000 ERU
o 0000
0.0000
1 0100 Peak PM Trip
o 0000
o 0000
1 0000 ERU
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LOT 4
EVERGREEN STATE BUILDERS
YELM TERRA
15839 YELM TERRA WAY SOUTHEAST
YELM, WA
STREET LIGHT
"'-/ - --/
WATER L1NE-- -Y-E-LM--T-E-R-RA-]AY;-SE------
~ -=- =--=- -=- ==-=- -=- ==-=- - ~~ -=-=- -=- =-=- - -
SEWER LINE I
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CURB
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105th A VE.SE. \.(
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SEWER LINE ~=--==----=-=-=---=-===-0~-=-=-=---=-=-=-==----
STR(ET L~'GHT
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~~SITE PLAN
@ 2004 CASCADE RESIDENTIAL DESIGN, INC
THIS DRAWING IS BASED ON CLIENT-PROVIDED INFORMATION REPRESENTED TO BE ACCURATE
AND RELIABLE. ANY DISCREPANCIES BETWEEN THIS DRAWING AND THE ACTUAL SITE CONDITIONS
ARE THE SOLE RESPONSIBILITY OF THE CLIENT
ProjoclAd-4J?" p ~7 ~~~) ./~?4____
SUbdivlakln:):1 eJ~L-YLL#t LoI # -.fL- lor"'fI;,S-qJ,9fi: -/(f!:!i!.1 j
'~ew ("lOnstrut1iun ,lJ Re-Madell R&-Hoofl Addi!loh U HDMe OcclJpatit," Silln
u Plumbing lJ Mechanlcol l) Mobile I MonYlfuctm'ed Home PIat.'t!Jr'fltllnt u Ortler
Project Descriptlor,J8oope of wurk:>~~ldLfJ.le. -f('(1r!.!.~'j_ e~,,~ ditlf:l ftJd__
Project value:J"3>Lf I 'l. !)D
- _..------...-.....--...............~---~._---_. -....-..
Building Area (stl 1l) 1~i FIOOr.~ till Floor.ctS"~ G&relge ~!lL'i.. Dock.
BI:tSBmant Carport Patio ,;2.J '=='
# B9dl'ooms_~. # Bathroon\IIl.2:- ~ H0811t1g@THER or ELE;mlC (Circle One)
Are there any (!mvlttmmantally !\18I1Sit/Vl:9 araa$ locatad on the parcel? ~.____ If YSII, a
completed BnlflrOl1trlun'al checklls! must accotnpany permit application
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ADDR~. ..1..:. l.iSJ.:;'L. ::..Li2t.?:...t/i~71J~-<2..:5t(.(l~;i-EMAll L~.- "12::." 'CJil~;JJl~-t.
. CITY. ~~~~T~TE~.k_l.IP~:t!t_ rELtPHONEas~} ,... -..:' ~ ~'.
[ARCHrfECl'IEN.GI!~~En7W:~Z<trl~t~~~ICE.N$E.#-=~-- . . . ~ ]
ADDRESS '_':,~~~~~;.z , ~EMA!tt5~_
E!!!~~~~~STAiE~~.r~ZiP]14~~~~~~~~o&~2E31 "2lr:Ei.~ .
GENERAl. CONTft~C'rOR. ~~~7Ii/J,ti;j,:$'7J:lJiit(Jt~ rE.lEPHONE..~_=-~'-~--"=:"'-:---
AOORESS__..__--_._.~-._____._EMAlL __ ~ ]
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r-PLlIMBING ~OR~~UiJ~;rELEPHONE~~~J
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CONTRACT()R'~~ J..ICENSE #~ .~_..__.~ ~.... l;::.J(P OAT E._ CITY LICENSE # _____
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MECHANICAl.. COt\i1'RACTOR~d~~ ..'ifiEPH-ONE ZS:J -,K.7~J~ -J
ADORESSJ'S~~ ~~~~.__~________._J~MA.!t __"~____...__._._. .--'
CITY&,,~~_.__STATE...e:.4.._lIP ~ll~ .FA.,(_~__________.__
CONTRACT~~:~~ #I t!e..'f*' tt.~J"~ EXP OA TE...._...C~~~IC~~~~~ -~_. _. """'_
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Copy of rvllti~JliJtlon agr$sm(:mt wiih Yelm COrflf'i'IUrlily Sehools, if applicable
, htlMbV j:erUfy Ittllllhu ut,OYtl In~ur~I\l'l.tloil lIS m:ll'r'llte ljmj thot Ul" t;ui~flifm~~lcm mi. ui'ld Ihll (I~t:lI\l~IIl'my 1I11d tfj(J tIllS 0' the
ubOl/fl d&8tlrlbed pmpc1I1y will bIllrllllJcordullCIl with 'he 11IWIl, mlOlllimd ullJl!JluU~n8 uf 1hll titllltll ~f Washlngtoll ilnd "1'8
etay tit Vull'll.
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Applic,mt', SignatlJr,.,.,~"._-,........._.._, , Date
Owner' / Contractor(Owner's AQ!!J1J Contractor'a Agent (Ph:UUUif tlirGI, une.)
-~...............
All permltl are l'torl'.tranSfell'ilbie *nd wUl 9>><<plr" if wurk l~mU~m'i:tf)d by such permit II not bcigun
within 180 days of il~guarlt:8f or if work II $u!llpehdiBd Of ab~ndon.d f(t!' a period of 180 duys
----......-........-.....-....-.................-....
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