BLD-05-0242
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crn' of YEl.tJI- BUIl.DING DEP ARTtJlENT
RESIDENTIAl. CERTIFICATE OF OCCUP ANCY
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RemarKs
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Plan Number
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Building Address
owner Name
owner Address
Building permit Number
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Areas Inspected
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Date
special conditions
Building OHicial
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,hiS strUClure is in compiiance wilh Ihe Inlernalional Residenlial Code (Chapler
51-51 WI<C) as adopled by lhe washinglon Slale Building code councIl pursuanl
10 Chaplers 19 21 and 10 92 R CW, elleclive July 1, 2004
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FROM YELM SEWER DEPT
FAX NO 360-458-Ul 66
Ma r 07 2006 05 04PM P 1
FAX TRANSMISSION
CITY OF YELM
P.O. BOX 479 - 931 NP ROAD NE
'\ YELM, W A 98597
(\ C\R\ 360-458-8411
\C) 1\ FAX 360-458-8166
TO: G.-R ICY,H6tJ DATE: ~ -7- 0 (.,
FAX#:
PAGES: I , including this
Cover sheet
From: KJ,.^J 1') Y
Subject: 14 I) u 3 E l=- l ,J f-) L sly
- t:' L h'\ 11:-12 ~,A
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COMMENTS: LOT 11/ /':';-11 q ) 6 '-/7];!. A J IE""" .s. c;:
LoT q 5; 151/0 '1E" L m r,j-l -12 () /\ U
I e 11...,/1 LV A IS, t;;:
\ Cyj -C]9~) C(;
h If you do not receive all copies or any copy IS not legible, please call (360) 458-8411
as soon as posslbk.
CITY OF YELt\1INSPECTION LOG
:\DDRESS
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PROJECT
PE~\llT NU~1BER
FOOn~G
~ 11"
o 16"'
:J other
8 requlred \ ents
\\' -\lL REB-\R ./ D:ile ~ CJf/V/
WALL
C} 6"
o 8"'
D other
SET BAChS
~\ Front
~ Rear
~"^'\) \\-\ Side Fbrlmg
v \\ SIde
FOOTI'\G REB-\R DJte
C o!"!:!T!e!::~
CO\l11I~[D FR.-\ \lEI L\. TERlOR SHEAR \\ -\LL I'\SrECTIO~
Hold downs :J
Frame ~
Plurilblng ~
Shear ~adln~
Gas 'Propane "'9
\1echanlcal ~
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Comments
I'\Sl L-\TIO~
~ Gas
~ Foam and Se31
::J ElectriC
~ \'2Por b,rner
" Other
- P\'-\
Comments
SHEET ROCK/SHEAR \\' -\lL '\ -\IL
Comments
OTHER
Comments
FI '" -\ L
--a Se\\ er FnJ]
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n Electrical
1] Insubtlon
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0242- YL
Issue Date 08/10/2005
(Work must be started within 180 days)
Receipt No
37959
AJ:lplicallt:
Name: Evergreen State Builders
Phone:
253-475-6622
Address. P O. Box 39753
City' Lakewood
State, WA Zip 98499
Property Information:
Site Address. 15810 Yelm Terra Way SE
Assessor Parcel No. 85840009500
Subdivision: Yelm Terra
Lot: 95
Contractor information
Name, Evergreen State Builders
Contact: McCullem, Tom
Phone. 253-475-6622
Address, POBox 39753
City' Lakewood
State: WA Zip: 98499
Contractor License No, EVERGSB980PB
Expires. 10/02106275
Business License. 1042.0
Project Information.
Project: Yelm Terra
Description of Work: Plan 2502 S/2, Lot 95
Sq. Ft. per floor' (1st) 1034
(2nd) 1467
(3rd) 0
Garage 461
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 1,408,90 993.75 415.15 5 6000 741340 $1,000
Building Plan Review 595.26 0.00 000 o 0000 o 0000
Mechanical Permit 78.75 000 000 o 0000 o 0000
Plumbing Permit 132,00 20.00 112.00 7 0000 16,0000 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 0.00 0,0000 o 0000
Water Deposit 40.00 4000 0.00 0.0000 o 0000
Traffic Facilities Charge 757 50 000 757.50 7500000 1 0100 Peak PM Trip
Sewer Deposit 5000 50.00 000 0,0000 0.0000
State Building Fee 4.50 450 000 0.0000 o 0000
SewerERU 5 417 00 0.00 5,41700 5,4170000 1 0000 ERU
TOTAL FEES. $10,428.91
Aj)J:llicant'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/~ Dat~?-eA5
Firm 4'SA'5
# Sets of Prints:
Final Inspection:
Date: 3.-/t-Of'
By' tJf:;t1
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CITY OF
YELM
PO Bex 479
{elm ViA 98597
360-453-8403
IVED
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YELl\t1 COMMUNITY SCHOOLS
I LOCAL RECEIPT DI<'E~._~5
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FOR_M.]:,l ~a.tL~ fL~ ..ieJxn. _ldL~/f5,Xl,_'i5.
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ACCOllNT CODE AMOUNT CAS\1 GHeCK oCJ.
()D-I,M -# '" I Wif) :;, 5 $-----b~~~=-
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25556
By
Applicant:
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Address, POBox 39753
Name: Evergreen State Builders
Project Information.
Project: Yelm Terra
Description of Work: Plan 2502 5/2, Lot ~
Site Address 15810 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
032001-322-10-00
Sewer Inspection
Water ERU 715401-343-80-02
805412-343-80-00
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
PAID
AU6 1 0 2005
CITY OF YELM
Permit No BLD-05-0242-YL
3 1 C{ ~J
City' Lakewood
Phone,
State: WA Zip 98499
253-475-6622
Assessor Parcel No. 85840009500
Item Fee Base Amt
1,408.90 993.75
595.26 000
78,75 000
132.00 2000
145.00 000
1,50000 000
300.00 300.00
40.00 4000
757 50 000
50.00 5000
4.50 4.50
5,41700 000
$10,428.91
41515
Unit Rate No, Units Unit Desc
Unit Fee
000
5.6000 741340 $1,000
0.0000 0.0000
112,00
7 0000
o 0000 0 0000
000
145 00
145.0000
16 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 1,5000000
000 o 0000
000 0.0000
757.50 750 0000
000 o 0000
0.00 0.0000
5,41700 5,4170000
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LOT CjS
EVERGREEN STATE BUILDERS
YELM TERRA
15810 YELM TERRA WAY SOUTHEAST
YELM, WA
IT -- 22 ..02:"-" -- 11
; i ,22 JlSBL__ - - -l i ;
sq 440-~O
I PATIO BELOW I
DECK ABV.
SIDEWALK
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: YELM TERRA WAY $E
WATER L1NE~-= -1- - =-~---~-= - - -.l_~_~
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SEWER LINE - -- - - ~-- ---- - - - --- --- - --- ---
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. SITE PLAN
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@ 2004 CASCADE RESIDENTIAL DESIGN, INC
@
NORT~
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
ProjootAd_~~~;r,-___~%: _I/_~~__ 4, ..p~('<,
SlIIlIIivitlkln:i''''J hLZ.~a::A. lrA 1/ $.s:..... Z"'."1f. ~ _--ft.ft1tJ ~ ~ 0" '/ ~ ~
'~ew \A".mstrucliun ,U Re-.Mod811 R&-Hoot I Addi~otl U HDme OcclJpatil1n Sign ,.p} <:'~
u PlumblYlg lJ Mevhal1lcol l J Mobile' ~av\wfu~tm't1d HOMtf PI8L"tiJfYlent U 011'1191' I' cY
Project D88crjption'~:oope of work:.~~le. -f(.,{A'!:i I (!J--f~.,~.( dM.l I t:(., .L__ ,00
projectvPJ'ue:~fp9J q~--o -,---~----- -..- UV
Building Area (stt 1\) 161 Floor..g?~ tlU Floor.14~1 G~t'ag9 ..':!'-L DackJ ~
Basement Cafport___._._Patio~ k~
# Bedl'ooms_S # Bathroom~~ H0~ll€~THER or ELECTRIC (Circle One)
Ar'e there any tli~jVltOtlm9l1tal/y $~msitivl9 araalillocatad on the parcel'? _.____ If yell, a
completed anvlrOhmun,al checkli~~ must Bccotnpany permit ii1pplll::ation
BUlihlNG OWflEflNAME::=IJ" .t1:-t'~. -:;', ~S;!Ii -.'LJ.?ZHil~- //~-' . ,L ," ---j
ADDRESS .~,:1f{[;'L:::.Ll2fZ__tt \. ,#, I., / " .EMAil L~'-.~~JiL~'1(.J2:-t
CITY ~~~",,_~TArE~_lIP~_ll_~fLtPHONE .. '~~, .. ,....:.:...~<<~;z:..
[ARCHrrEClJEN,GI!~iER7Fl:~2&lgrl~~e~it~lCiCE:~N$E #1 -=_-- . ,._
ADDRESS .~0_~'~:;;~. . ~EMAlt~_ ___
E!.!!~tW(~~~STAjt~I~~~~~::tE~~EPHO~~,"Z,)~ ZlfGfl:l.a..
G~ERAl. CONTRACTOR. ~'5tl/!llltti4~'7fl7/Jl.ift-- tEU~PHONE~__=--'----"_::-:-::--
ADDRESS ....._.._.....H______,..__. __._ EMAll ~_____
CITY STAn: liP FAX
oONfRAs.~~R:~l~~~~~~Ex~~ni(i!~:(rY UCENSE II.
PLlJmINGC9li~OR~W~'rELEPHONE~j~J
A[)(JRE~~/~i- !_..~~..r._.n-_-~%.~AIr--._EMAil .~--~~":~~-
CITY 7t1.l~!jJYI7 __~nATE~_lIP:t ,.Y','(.,_JAX....;Z.s:.~~~.::.9 ~_.~,~-
CONTRACTOR'$I~IGENSE #_ .~_. ,~._ .... FJ<P OATE___CITY LICENSE #____
----'~_..._"'___.""""'_...~:.r.J1'ti... ~...._...._...._........_..w..............._~ ~... ~....lt
MECHANICAL COf\?i-RACTOR~&I.'L~~ ' _.fEiH."JH-ONE Z.i':J - L71J::.J;t:!?2 -J
AOORESS~~~~o!t:__________J::MAlt ._.____.__._.____
CITY&,,~~ _.___STATE.~A' .._liP ~L?'r .FA.l(.__.__________
CONTRACT9R'S .!:!~~EN~~ 1# ~~'"' ~~..= EXP OA TE.....__.~Crr~~IC~~~~~......,' . _ .' ''''''''_
~,,~
Copy of rYllti~l(,Jtlon agrfJsrm:mt wiih Yelm Cort'lf'l'IUrllty Sehools, if applicable
]
, /ltlffiby l:eftlfy Ihllllhlf utlovO hdurmatlon 111I l~l:l~ta Iimd thut Ul'l t;tmfltrl.l,~~IUfI on, tmd Inv U~I'lIU'jtlllney and If.v ulle or the
ubuvfI dtlsm'fbed PM1HI11j/ will be hI IllJtlordlll'ltfJ with the lawlI, mlull il1no UI{JIIJllltlGlfl!l of the 8tlJllll of Wllllhlnll1lln and l"e
Chy tlf Vulm.
____~L~~.--- --~_.__._. ~~~-:_.
Applicant's Signatur,.~.~".-,........_-~.-. Date
Ownel'i ContrDcto..(~~~r'lI ~!!J1i Contractor's Agent (PiuIMe cin,;l. anc.)
All permit. are norl.lrllnsferabie and wU! OlP'''. if work Ilmthtniz:td by such permltllll not begun
within 180 dave of ~~gUI!nU,~8, or if work Is $ulpendtd Ot abandon.d ftn 8 period of 180 days
---.........._~-_..._..~
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10,6 frlm Averun/Welll (9()O) 4"UW FAX
PO Bur "'II} .
Yfllm, WA 1Jw/Jln wUlw.tlI.,)'cdl1i.WIJ.Wl