BLD-05-0243
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CITY Of YELM _ BUILOING OEP ARTMENT
RESIOENTIAL CERTIfICATE Of OCCUPANCY
Building Address
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RemarKs
~nS~
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Plan Number
~
owner Name
owner Address
Building permit Number
~43-YL
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Areas Inspected
Date
special conditions
Building Official
~
ihis structure is in compiiance wilh the Interna\\onalHesidentiat Code (Chapter
5\-5\ WI<C) as adopted bV the washington state aulldlng Code CouncIl pursuant
to Chapters \ 9 .27 and 70 92 RCW, e<<ectlVe JulV \, 200'
~
FROM YELM SEWER DEPT
FAX NO 360-458-8166
Feb. 13 2006 11 llAM Pi
FAX TRANSMISSION
GAR~ _
TO: &12~0
CITY OF YELM
P.O. BOX 479 - 931 NP ROAD NE
YELM, W A 98597
360~458-84] 1
FAX 360-458-8166
DATE: :2,""' 13 ._, bl..o
FAX#:
PAGES: I, including this
Cover sheet
From: 'KP).uD y
Subject: \-10 LtSC; F \,0,.,\ L / '-! [L\'V1 IE RVi
COMMENTS: LoT )~) ) 57~1 YELYh -n;r2.RA /.UAl.( <;'.~
05-5 jCJD au
** If you do not receive all copies or any copy is not legible, please call (360) 458...8411
(\s soon as possible.
CITY OF YELi\1 INSPECTION LOG
C PROJECT-IJ!t1/n) /b /0 "R./kB ~f I L
PE~\1IT NUMBER 0 5:- 0::>. L( 3
';DDRESS I 5~f5 J ~/tA/[ ~A/rq ~ SC-.
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1J~C\)~
SET BACkS D:lte
Front
Rear
Sdefbrllng
SIde
FOOTI'\G REB.\R
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1../
S""
/'~3te
FOOn~G
~ 12"'
o 16
Cl other
8 requIred \ ents
W.\LL
iJ 6"'
o 8"'
[J olher
~)vIt
,
\\' .\lL REB.\R D:i1e
C 0!1~!'!1e~t~
CO\lBI:\ED fRA~lEI E~ TERIOR SHE.\R \\ .\LL I\SPECTIO~
Hold downs :J Shear ~311Ing =
Fr3rne"l G3S 'Prop:me ]
Plur;]bIng :J \1ech3nlc31 ]
C Comments
Comments ~
l G~s
7 Foam and Seal
~ ~(R. cf (.H,~
J Electnc
::::! \'3por D3ITler
~ Olher
j P\' -\
I'\Sl L.\TIO"-'
SHEET ROCK/SHEAR \\ .\LL '\ .\IL
Commenls
OTHER
Comments
Fl "-' .\ L
u Se\\ er Fn31
:J ~dJres5
n Electnc31
:J Insul3tlon
J C1\ d Final
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:::J L2ndsC3re FIn31 CJ C dO
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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
Permit No
BLD-05-0243- YL
Issue Date. 08/10/2005
(Work must be started within 180 days)
Receipt No
37954
Applicant:
Name: Evergreen State Builders
Phone:
253-475-6622
Address. POBox 39753
City' Lakewood
State. WA Zip 98499
Property Inf~rmation:
Site Address. 15~1 Yelm Terra Way SE
Assessor Parcel No. 85840001200
Subdivision: Yelm Terra
Lot: 12
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: 1042.0
Project InfQlTlla~ion
Project: Yelm Terra
Description of Work: Plan 1610 R/2B, Lot 12
Sq. Ft. per floor' (1st) 1640
(2nd) 0
(3rd) 0
Garage 470
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 1,09090 993.75 9715 5 6000 17.3490 $1,000
Building Plan Review 460,90 000 0.00 0.0000 o 0000
Mechanical Permit 7175 000 000 o 0000 0.0000
Plumbing Permit 111 00 20.00 9100 7 0000 13.0000 Fixture
Sewer Inspection 145.00 0.00 145.00 145.0000 1 0000 ERU
Water ERU 1,500 00 000 1,500 00 1,500.0000 1 0000 ERU
Water Meter (SFD) 300 00 300.00 000 o 0000 0.0000
Water Deposit 4000 40.00 0.00 o 0000 0.0000
Traffic Facilities Charge 757.50 000 757.50 750 0000 1 0100 Peak PM Trip
Sewer Deposit 5000 5000 0.00 0.0000 o 0000
State Building Fee 450 4.50 000 o 0000 0.0000
SewerERU 5,41700 000 5,417 00 5,4170000 1 0000 ERU
TOTAL FEES $9,948.55
Applicant'~ 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.
# Sets of Prints.
Signature ../ ~ -
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Firm /S~
Date #-/6 -,,~
Final Inspection:
Date: Z -1'1 -0 f:
By' tJfII
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~ CITY OF
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yelm WA 98597
~~,,,. 360-458-8403
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RECEIPT No 37952
RECEIVED FROM
DATE
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RECEIPT No.3 7954
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YELM COMMUNITY SCHOOLS
I LOCAL RECEIPT DI<TE~.~OO5'
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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. P.O. Box 39753
Project Information:
Project: Yelm Terra
Description of Work: Plan 1610 R/2B , Lot 12
Site Address. 15881 Yelm Terra Way SE
Fees.
Item
Building Permit 1 00-50 Ok 032001-322-10-00
Acct Code
Building Plan Review 100001-345-83-00
Mechanical Permit 032001-322-10-00
Plumbing Permit
Sewer Inspection
032001-322-10-00
Water ERU 715401-343-80-02
805 412-343-80-00
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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Permit Fees Schedule
AUG 1 0 2005
CITY OF YELMJ
?;lQ'5 J
City' Lakewood
Phone:
Permit No
BLD-05-0243- YL
State: WA Zip 98499
253-475-6622
Assessor Parcel No. 85840001200
Item Fee Base Amt
1,09090 993.75
460.90 0.00
7175 0.00
111 00 2000
145.00 0.00
1,500.00 000
300 00 300 00
40.00 4000
757.50 000
5000 5000
4.50 4.50
5,41700 000
$9,948.55
9715
-
Unit Rate No. Units Unit Desc
Unit Fee
000
56000 17.3490 $1,000
0.0000 0 0000
0.00
9100
7 0000
o 0000 0.0000
145 00
145 0000
13.0000 Fixture
1 0000 ERU
1 0000 ERU
o 0000
o 0000
1 0100 Peak PM Trip
o 0000
o 0000
1 0000 ERU
1,500.00 1,500 0000
000 o 0000
000 0.0000
757.50 750.0000
0.00 o 0000
000 0.0000
5,41700 5,417 0000
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LOT 12
EVERGREEN STATE BUILDERS
YELM TERRA
15881 YELM TERRA WAY SOUTHEAST
YELM, WA
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STREET LIGHT
WATER LINE --------\----,1-----____,__
YELM ITAAA WA SE I
SE -------- ,,' I
WER L1NE~ - T ~ - - - - - -- - - -- '-""""- - - T-----=-
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LAN 1510R/28 I~.
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15.
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PATIO
- -50.00' - -
CURB ~
105th A VE.sE:'
-----------------------BL--------AD pt""\;. r:: i 1
. ~:~E~ L1:L~:--- -- --m----__-.=_~__~~~;./-~~iPr~
.
@ 2004 CASCADE RESIDENTIAL DESIGN, INC
SCALE I' = 30'
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
prOj"",Add_.;{)'~yeh_7.?m--o/ ~O.&/~ <2____
SUl1divl81on;_~ e !hL.&iJ::A:. lIll # ~ 1"""9; ",5-1l.~. -ftttltJ J
'~ew r.onstrucliun ,u Re-Modell Re-Hootl Addition U Home OcclJpatitnl Silln
u Plumbing IJ Mevhal1lcol lJ Mobile' ~~m\JIl'octul'ed HOMlf PloofJrYlent U Orher "p
Projeot D88orjptlon"~;oope of Work: .'.?SAA1 &I it:. -ft../A't/I / 14 f!e .~-t rifc!.fll ce. I ~
~v ---r::-j-~~"'"' ~::::.L______ ~ \.. ".
Project Value: -2~? 7'S'O _._____~__ ._.._. ~o ~?
Building Area (sQ lU 181 FloorL6E 2M Floor.__~._ G~reltJa ~7~ Deck , . -?'~ ~
Batiiemant CsrPtJrt.__, PatiO. Z/6u ,
# Bod""'m.~ # BBlh/'lJl.ll"._L H"'fl~nlER Of ELECTRIC ICircl. One)
Ar'tJ there any 0~jvltotlm9l1tally !lJ~I1&itiv19 ar9!'1l1llocatad on the p!]rcel'?__.__~_ If yt:JIi, Ii
completed Bi1vlrol1rrmntal checklist must accompany permIt application
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r BUiLolI~G OWHEfrNAME~~;tL:giUtq{:,?~ '
AOD.~.S ,~,,:1JSj:;';"::,.LQ{:Z.~~.~ \.' t...~~_EMAil L\$..~~t= 'C{ly~1(.J1.~-/..
ern:: . ~_~~",,_~T.ATE~b_l!p_~~J:_n:U~:PHONE '.C~' ._ -..:,:" f, ~'.
[ AR~ITECT~.G"~iER7YY~~Z&I;.zr.l~t;r~~ICE.NSE. # -=~-- . . , ~
ADDRESS ,_,::~_~~~;'~ _ . ~EMA!L~~ ,
CITV ~?(~:tt=_)nA rt~I~~ZIP~~~~~~EPHo~E(2Ci1.12ri:ifZ2iI:,
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GENERAL CONTRACTOR.~fl'!' TELEPH()I'IE.~__ -"-J
ADDRESS ,...._.._..... .__...___. ___EMAIL ~_____
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[-PlliMBING Cpt!T!~~P~~~~t~blifjl~~1'f2LEPHONE~3'7=8:~'J
ArJ[}~~/Jirg ~~_....:....W t::/:-..7r__~%.~p:__._EMAil 'M"_~~-:~~_
CITV ...J.a.~~IJ)?7lC..~~HA TE~_lIP :.t '(".__FAX-,~~~2~'::.9." _._.~_
CONTRACT()R'~~ I..ICENSE #_~ ,__.._"~ . .... t:::XP DATE__CITY LICENSE #_____
........-.~..........__.._....._.~_...-...'t.l1t:i.... . ~_.....~.............................-~ .-.-.,...... .~, , ~......
-MECHANICAL CO~?i-RACTOR~.uL~~.__.'fE'LEPHoNE M3 w.L7JS::J~_ ]
AOORESS~~~~~____.____~__J~MAIl. ._.____.__._._.__
CITY.&,,~~ _.__JHATE.~.4 "._lIP ~L?'L'_.FAX_____._______,,__
CONTRAC'r9R'~..!:iSEN~~ #~~~(f~_.- EXP OA TE,".,_.._C~~!..~IC~~~fL#~.,_.===_
I!9t1# "......,
Copy of mitigation agresl'tlfMlt wiih Velm COl'flfl'lurllty Seh(}t)ls, if applicable
]
I t.ll~by j::ortlfy Ifllll (hlf uilovtl11I.urmfitloil111I l~ltIO'llCe aild !hut IIUl! lJlm5'tr1.l'~UUt'\ un, tll\d In41 Ol:lllUplll'my Dlld Itl., UII8 6' tho
ubUIl41 dftscrlbad proP<<ll1:v will billn 11lalUrdllm:e with ttlslllWIl, mlulIllInd ~~gillfutl~n8 of 111M .'bIle of Wllshlngtlln and lhe
CIC)I tll Villm.
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Applleard'S ~~Jrt.:_...........,--_._, Os
Owner I Contructor(Qwner'lI A9!!J1i Contractor'lIl Aguo' (Ph:UUle Clin.l. one.)
--_.......~
An permit. aI's non~trarllSfell'llbie *nd wUl o>>tplrll if wurk IlmU~owb:f)d by such permit III Mot begun
within 180 days at il&lliltuarle8, ot if wark II $ul!lpended or ablMndnned feu a period of 180 dliys
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