BLD-05-0246
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CITY Of YELM - BUILDING DEPARTMENT
RESIDENTIAL CERTifiCATE Of OCCUPANCY
Building Address
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owner Name
owner Address
~enS~
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plan Number
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RemarKs
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Building permit Number
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All Code reQuired
special conditions
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Areas Inspected
o ate
Building Ofticial
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ThiS structure is ',n compiiance with the International Residential Code (Chapter
5;.5; WAC) as adopted bY the washington State Building Code coune'll pursuant
to Chapters ; 9 21 and 10 92 ReIN, effective July;, 2004
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FROM YELM SEWER DEPT
FAX NO 360-458-8166
Jan. 12 2006 04 30PM Pi
FAX TRANSMISSION
b~e-~
TO: f::r(2. 7f 1./ l3AJ
CITY OF YELM
P.O. BOX 479 - 931 NP ROAD NE
YELM, W A 98597
360-458-8411
FAX 360-458-8166
DATE: }-):l- 0 Co
FAX#:
PAGES: I, including this
Cover sheet
From' ~,oO Y
Subject: I-t b.... ~ IE' P I Ai A J l.( I; I. W) 'IE (t,.~
COMMENTS: L...O 7 77 15*7d.."::t' J t;,~ Ave · S.. E.
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(j S ---57) b . 00
*'" If you do not receive all copIes or any copy is not legible, please call (360) 458"8411
as soon as possible.
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CITY OF YELt\1INSPECTION LOG
'7/~) 17YO/J'0
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-\DDRESS (57d, S /0 y,!--1 A-ut - Sf
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PROJECT
PE~'11T l.,JUMBER
SET BAChS Date
Front
Rear
SdeFbrlmg
Side
?-€>
</v
&,
7
/DJte
fa f 77
FOOTrNG
~ 12"'
o 16
Q other
~ requJred \ ents
WALL
~ 6"
o 8"'
o other
9) z-- W -\ l L R E B -\ R """"---D:il e ~
C 0!::!"':e':~s
J Electric
~ \';:por t.:'.ITler
" Other
- P\'-\
CO\l13I:'\[O FRA \lE/ E~ TERIOR SHE.\R" .\LL I\SPECTIO,", ,
Hold downs :;. Shear :--Jadmg 'C l>~ .~
Frame A ~ [elU Gas 'Propane X 1J/r..11J~1
Plu~bt~g z:, qu \lechonlcal - .
comments_~J-- \0 ' ' A thE AUe.&(
I '\Sl L.\ TIO, ~ Gas
~ F03m and Seal
FOOTI'\G REB.\R
Comments
SHEET ROCK/SHEAR" .\LL \ .\IL
Comments
OTHER
Comments
F1~AL
"'s Se\\ er Fn:;l n Electrlc3\
'::J ~ddress "i;. InsubtlOn
:J Cl\llFlf\3\ ~ Lmdsc;;re Flfl31 Q cero
o Slle DrJlllJ;;e 'I Sldn\ .Jlk
Comments
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0246- YL
Issue Date 08/10/2005
(Work must be started within 180 days)
Receipt No
37956
AppUcant:
Name. Evergreen State Builders
Phone:
253,475,6622
Address. 3815100th St. SW, Ste 2A
City' Lakewood
State. WA Zip 98499
Property Inform~tion:
Site Address. 15725104th Ave SE
Assessor Parcel No 85840007700
Subdivision. Yelm Terra
Lot: 77
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. 10/02/06275
Business License:
Projec::~ Information:
Project: Yelm Terra
Description of Work: Plan 1740B/3, Lot 77
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 78.75 000 0.00 o 0000 o 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 1 500 00 0.00 1,500.00 1,500.0000 1 0000 ERU
Water Meter (SFD) 300 00 300.00 000 o 0000 o 0000
Water Deposit 40.00 4000 000 0.0000 0.0000
Traffic Facilities Charge 757.50 0.00 757.50 750.0000 1 0100 Peak PM Trip
Sewer Deposit 5000 50.00 0.00 o 0000 o 0000
State Building Fee 4.50 450 000 o 0000 o 0000
SewerERU 5,41700 0.00 5,417 00 5,417 0000 1 0000 ERU
TOTAL FEES $10,038,41
Applicant'~ 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.
Signature/ ~ - Date ".",4- ~
Firm /5/5'
OFFICIAL USE ONLY
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Final Inspection:
Date: I-I ~- d y-
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~ CITY OF
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r "- PO Box 479
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RECEIPT No 37 955
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'?; 1 Yelm, WA 98597
~ 360-458-8403
RECEIPT No 37957
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Applicant:
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
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Name: Evergreen State Builders
Address. 3815 100th St. SW, Ste 2A
Project Information"
Project: Yelm Terra
Description of Work: Plan 1740B/3, Lot 77
Site Address. 15725 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 420 120-345-85-00
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 2005
CITY OF YELM
Permit Fees Schedule
Permit No BLD-05-0246- YL
1/C{kJtp
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Phone.
253,475,6622
City' Lakewood
State: WA Zip 98499
Assessor Parcel No. 85840007700
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
-------------
1,14915 993.75 155 40 5.6000 27 7500 $1,000
485 51 000 000 o 0000 o 0000
78.75 000 0.00 o 0000 o 0000
111 00 20.00 9100 7 0000 13.0000 Fixture
14500 000 145.00 145.0000 1 0000 ERU
1 500.00 0.00 1,50000 1,5000000 1 0000 ERU
300 00 300 00 000 o 0000 o 0000
40.00 4000 0.00 0.0000 o 0000
757 50 000 757 50 750 0000 1 0100 Peak PM Trip
5000 50.00 0.00 o 0000 o 0000
450 4.50 000 o 0000 0.0000
5,41700 0.00 5,41700 5,4170000 1 0000 ERU
$10,038,41
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LOT II
EVERGREEN STATE BUILDERS
YELM TERRA
15725 104th AVENUE SOUTHEAST
YELM, WA
STORM- UNE- - -- - - - - ~ - - - - - - - - -- - - - --
------------
-----------
SEWER LINE
--,------
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- - - - -= - -, - =-~---~-= - - - T (;l-I
WATER LINE I I -----
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: 104th AVE. SE :
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SIDEWALK
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:~ LAN 1740/3 II
~ ~ I ' (GARAGE RT) ~ i g ~
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:L _""_ ~7 ~ ~r//~J~
o 25' BSBL 0
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LL--------j-j
6000'
eESITE PLAN
CQ 2005 CASCADE RESIDENTIAL DESIGN, INC
@
NORT~
SCALE I' : 310'
THIS DRAWING IS BASED ON CLIENT-PROVIDED INFORMATION REPRESENTED TO BE ACCURATE
AND RELIABLE. ANY DISCREPANCIES BETWEEN THIS DRAWING AND THE ACTUAL SITE CONDITIONS
ARE THE SOLE RESPONSIBILITY OF THE CLIENT
proj8r;tAddra~S;LC~r /,t7~?~~~ ~ ~~l~L~6 _"_..,~__
Subdivl8illn;~ fUM.:..q, Lor # -2.2.._ ZO";III1. ~'Jk --fttt!iJ./'j
'~ew C'.onstrudiun ,U Re-.Modall fie-Hoof I Addiijon U Herne OcclJpetit1" Sign
u Plumbing IJ MBVl'lfll1lCOI lJ M()bll~ IlViav~lJlfuctm'oo HOMtf PIIWt!JtYlent u Olhar
Projeot DEl9crjptlo'1J~;OOpe of Work: ,~~i:1Lf}..le. -r;"A-.rl.l ~!J--!l.ff~ .5..( r1~ll 'J.; i__
Projoct Value: ~ '3>&.\ , '\.>0_________
Building Area (stl 11) 191 Floor.,,~~ till Floor.9~~ G~raga JLl ~ Dock .
BaSBment___ C8r'Port_~._._patio~
# Bedl'oomsZ. # BathrOOm$..6.'S H98tjrrg.~THER or ELECTRIC (Circle One)
At'S there any tlI~'\tltOtlmol1tally S6rl!.'iit/VIIl areaM locatad on the pumal? _____~ If YIiJII. Ii
completed anv!ronmuntel checklist must accompany permit apphtation
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BUll~DING o~E~~fNAME:=rr~~~~ ~~. . ~.'L7:.?iJ.; 7i1lIL,?~-/j
ADDRESS .~,:?1fL~;'L;':.L'Q{'2.~' .~t \ . .' t, J ,.. _EMAll L\,\.~ 'C{lY~1tJl.-:/.
CITY ~~~m=..~TAni~_l!P ll_lfU::PHONE" .~~" ... ""'':;';' ~.
[ARCHITECiiEN.G'NliEn7fY.~S'z~t(rl~t;ra;~trjCENSE # -=_----:-- , ,~ ]
ADDRESS ,_~0~~~~;'~, , . ~EMAlt~~
E!!Y~~~slArt~I!~~~=-~~EPHONe:2l33.2 2r5~
GENERAL. CONTR.~C'rOR. ~SU~(l4,$ 7fi.T/itiJt." n:'LEPHONE"__=--'-~--"~-:--J
ADDRESS '. EMAll ====
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[-PLliMBING. cpt!. T~~O~B4: .~T~. ~iir~TELEPHONE~S2i2:~J
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C9N!.~.f]-()F,t.:!.~~~!.J~-;r..,,==~,,"~~_~E,_=CITY LICENSE # _----=:.
MECHANICALCO~n-RACTOR~~L~~....niiF.PHONE M:fu.L?.s:::J~ -J
ADORE::SS~~/.l:~t!t:___.._._____J~MA!l. .___._~.__._.____
CITY&,,~~~.___STATE.~A .,_lIP ~LZC .FAX_~_,_______,,___
CONTRACT~!!lg,~!~E~~~~~~J_ _ EXP OA TE.,,,.,__._C~r.y"'~IC~~SE ~#.-.~ '===r:._
peJ4/> 4"'-
Copy of rYlltiOtdtion agrl!lsrtltmt wiih Yelm COl"I'lf'l'IUt'lity Schools, if applicable
I htll'flby t:ertlfy Ihllllllll u'lIovtl bdumlilltlorl 15 l~<tIl'r'IIlje l.md Ihlt! Ul" l;;UMifU\~~IUl'l ml, ,md Ihe Ul:lllUplll'my and ttlV US8 uf ,.....
abo"f1 dtlltlrlbed pmlHl11y will btllrl !llmordlilllCll with the 11IWlI, mlllllli1nd nllJlllluU~n8 of thl! 8M" of Wllshlnll'l1l1l ~nd ,lIs
CU'lI tll Villl'lI.
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AppJleard'S Signatur,.~,~",_-"......_._............ nate
Owner' I ContrllctOf'(Qwner'l:I AQ!!J1J Contractor's Agent (Pluss. tin.I, I1ne.)
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All permit. are "cm-transfell'abie Ind wU! o>><<pl... if work IlmU~urb!ed by such perml' II Mot begun
within 180 daye of ij&ll9W!lt'lt8, or if wtnk II $u!Ypend~d Ot abandnned fal' a period of 180 duys
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(36/)) 4fl6--3i44 FAX
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YlItm, WA IJW/ipr