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BLD-05-0224 ffiIDJ@U@J ~J@lJ@lI@J~JTIIDJ@l~J@lj@lJ@!l@Jf@Jj@lI[~l1r@1Jf@1Jt~lj [~~ CITY OF YELM - BUILDING DEPARTMENT RESIDENTIAL CERTIFICATE OF OCCUPANCY Building Address 16211 Birkland St. SE Owner Name Owner Address Landshapes NW 1151 East 11ih St. SE Tacoma. Wa.98445 Building Permit Number BLD-05-0224- Yl -P1:m Number pbn 1924 Remarks Areas Inspected All Code required Special Conditions Building Official. G Carlson Date March 7, 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 19 27 and 70 92 RCW, effective July 1, 2004 ~1~~@Jt@[@J@fiW@1B@JI@1II!illJ~J@lf~~m:illJINJJffilJJ[ill CITY OF YEL!\1INSPECTION LOG c PROJECT W s /J ~l--- l~ . D-:rr / , 0\- C>z_.'z_~) PER..\llT NU~1BER -\DDRESS \~~ II B I ( Jll"...J 5J- ::::!F SET BAChS D3te Front ~(L/Rear -t)V0\."'u 4)'(; Sdefbrllng !Y ~q Side FOOn~G ~ 12"' o 16"' J other 8 requIred \ ents W';LL CJ 6" o 8"' o other W.\LL REB.\R / D~1le rA 9[( I FOOTI'\G REB.\R D3te Co!"!:r::e;-:ts CO\ 131;\ ED FR..\ 'lEI E", TERIOR SH E.\R \\ .\LL I \SPECTIO~ / iJ HoJd downs :::J Shear ~adlng = ./' \,l V it \ } F rarne ~Jr- Ilj~./ GasPropone /!. vA- 'JjJfa/ oV' Plur.lbng ~ ilJlZ~/{/'I" \lechanlc3\ ] I o CommenlS_~' i~ ;5~ I'\Sl L.\TIO,", J G;:s '] FO::lm and Se3.\ J E\ectTlc =:! \';;p0rbmer " Other - p\'; Comments SHEET ROCK/SHEAR" .\LL '\.\1 L Comments OTHER Comments fI~ .\L t Se\\er Fm.\ Q Electnc:J :J C1\ 11 Fln3\ l' .\dJress ~\n5ubtlOn 0 Slte Dr3lil3f'e " d4_ .17H~ / ::J bndsC3re FIn::Jl Slde\\ 3.1l~~ CJ C (,fO Comments c- FROM YEI_M SEWER DEPT FAX NO 360-458-8155 Feb. 23 2005 05.54PM Pi FAX TRANSMISSION n~ S~~\ CITY OF YELM P.O. BOX 479 - 931 NP ROAD NE YELM, W A 98597 360-458-8411 FAX 360-458-8166 FAX#: 1t;J I i ) DATE: ~-;:2 -3 -oCe, PAGES: I , including this Cover sheet Subject: 1-( 0 lJI ~'" PI!J A VA LlTl-l m.r0 H \ LL ]:t b 7 - ()~'(5 . , t31 ~LI<.LAAJ (j S c OCi 6 \ Rc.. )(, LAA..) (j :5 ~ \ /, C-) 7 _(l lCl[! -, 1 (( From: RAI\J 0 y COMMENTS. ~oT ~ /10;2./1 L6J ~~J l~d.IO * * If you do not receive all COplCS or any copy is not legible, please call (360) 458"84]] as soon a~ possIble o o ~ ~ City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Permit No BLD-05-0224-YL Issue Date 07/26/2005 (Work must be started within 180 days) Receipt No 37543 Applicant: Name: Landshapes NW, Inc. Phone: 253.537.6370 Address. 1151 E 112th Street City' Tacoma State: WA Zip 98445 Property Information: Site Address. 16211 Birkland St. SE Assessor Parcel No 32660000500 Subdivision: Autumn Hill, phase II Lot: 5 Contractor Information Name: Applicant Contact: Phone: Address. City' State: Zip Contractor License No: Expires. Business License. Project Informa.ti.c>n: Project: Autumn Hill, phase II Description of Work: 1924 SFR, Lot 5 Sq. Ft. per floor' (1st) 1418 (2nd) 506 (3rd) 0 Garage 462 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 1,431 67 993 75 437 92 5.6000 78.2000 $1,000 Building Plan Review 604 88 000 0.00 0.0000 o 0000 Mechanical Permit 78.25 000 000 o 0000 o 0000 Plumbing Permit 118.00 20.00 98.00 7 0000 140000 Fixture Sewer ERU 5,41700 0.00 5,41700 5,4170000 1.0000 ERU 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 0.0000 0.0000 Water Deposit 40.00 4000 000 0.0000 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 0.0000 State Building Fee 450 4.50 0.00 0.0000 o 0000 TOTAL FEES. $10,446.80 Appl icant:~.~~ffad~vit: 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 tate of ashi ton OFFICIAL USE ONLY # Sets of Prints. Date: By' ill r.'1::i Wj " ~j .' ~:; 'l Y', ,~~~ ~"'" .'. ~~ I'}~ : ~ ~. jp. ' . .~ ';I of<~ ~~,~ "lie 'll',.' Yelm School Dlstrl~t ATlN SUSAN CROY PO BOX 476 YELM, \'iA 98597 360-458-1900 ~:~ "~ I1';t ;:tJ .,j: -(~: ll'f.' 0 Ib.~ ,~: ~~ m ~'~ ~~ ~!'i l.,"t ~:;~ ~~~ ,:I~.! :1~ ~~ ~1J f;;; ~I:i rr",ij ~ ~-~ "') ~{~ ..1~ I,"~ ~11 . ..;~O l~;, "'~., 1'-1~ &'1 ~~~ ~~~1 ~~~ Solrl to 16054 LANDSHAPES NuRTH WESl INC, LANDSHAPES WEST INC LANDSHAPES NORTH 1151 E 112TH ST T ACOMA vIA 98445 II 6245 Reg 111 13 07/2G/O~ SGlesPerson SUSAN I' I ,,, Item II 295U/MITIGATIO~ MITIGATION/CAPITAL PROJECTS 1 ~ 8,560 00 8,560 uO CK #2491 rOR AU1UMN HILL 2 05-010 LOTS 1 ,2.5,7 SubTotal 8,560,UO Total Due Check 8,560 00 8,56U 00 Thank you PLEASE ~EEr lHIS RECETPT' I I \ !tJI'~ ~~~ l~.~ I ,f IIi'i'i ""' '" i' i' 'J ',' .' '. ~J ~I' . ~ ,! ~ if ~ ~ ., :l,,..,,\'- .., o o ., "~, "''' '11 ".. ~ Ii~(\', ~ - tf:.,.JJ -5 (f ___ .~.,.~...-.,,>-..._""~--""""---"'---'''''-''''''''-'''''.- \,t1C1 ; 1. ~.J l; 'Ct:'~ ! N _)) ~ \ <.:.~~" "-..~ ~~ " I [, ~~-.....,~~_.---- " r'--"~"~' ''....~:" ,~ 1"-,., I! ! ...."~ I 1 '\'if:1 r '......,'''}, --...1 f'; '. l 'l i41i~ ',' '~. C'~ 0. ::) . ... ,l 1 1[! \ ! I ! !, i . 1 j ~ f-~ 1 ,: "~c. \ f-~~ i ~ l' j I' \ '-~""'-'I ""I 4j 1 ! ~ :: II~----I I~-:- - ... I 1 "; t ~. ~ I .! .\ 'y!J \1 ~ / I f:, i )\ I \.>J ; I j \ I , f ~ 1 I \i\!'\ ,~ ,~~ _ _, ~ .~ .~,J..w'1W:l;;>:!~,,""-;,"~''''''~~~~'~~'''fflf*:'-''''':'':".~~:,~!:r'....',,,;::~..! "'~'" .~.", _l_.._ .Y__~._~~ - : F\'~. CO~\~ t~\RKt;'J,~ ~), ~ I~t. ,. -'ft=..~ A~.:J"f,.' \p" '1 t ' I-v ,).tf.......". -.- _.~- -'- y ..../.~.,-._--_. ___~_"._.-1)L~V.L.~-_._...._.- -c"f',_-"";"'_''','''' .~:,;,~,~~,,'.~;~'';:'';~: """\'S,~,;:;:", .;;.;:.,.,-_,~-::.".",.~,.,....":.""".>~~~'-' '. \....."..:';...\o..,~""_""',O.:;'.'""\'I.,',..,"':".,...;h~x~\~'.,,,.'... ~>""....\\.(.,~r....""'''^'''.:..>:I'>~~io/ ,''''''"",~"'''''''''''_'''''!I''''''1\I;.""".,,,;... ll-\ \\j DS\-\~Pt:5 \\bfttH Wt-sTj t\\)C. \ \5\ E t\ 2'Th 3T 'lA:G:)~1A: /WI\ CV:04Y5 253-501-03"10 ~\)~ {);{'1 f\\JtRESS \ LP'2l \ & RY:)L1\ ~ D ~\ tt. '~tU{yl, WA. f\~rj11 l()f #: c 5 R\ RlEl~ tt - f);'l:? ?f) \ ?l 0700 o ~Jtll!di ,",~h~nel iL~l i;!3d ~~ ~ ';~~Il ~ LJ i.J M ~~ \~:f.5/ \~GS' Ilnhwlsr~' Inc. 1151 East 112th Street - Tacoma, WA 98445 Office 253537-6370 - Fax. 253537-9163 c To Whom It May concern. o InfiltratIOn as desIgned on the engmeered plat shall be located m the rear yard of each lot t;l ~smeyer PresIdent ~ o o After recordil'l~ return to: Yelm Community Schools District No.2 P O. Box 476 Yelm, W A 98597 AttIl: Erling M. Birkland MITIGATION AGREEMENT Reference No; AulUmn Hill, SUB~04-0036- VI.. Velm, W A Gmllltor: I. John Lubbesmeyer Landshlllpe5 Northwest, me. 1151 E. 112''', Tacoma. W A 98445 Gll'8il11tee: Yelm Community Schools District No.2 Legan Description: A 30-17-2E S2 NE NW SE LESS RD 3 ( 7 ..,,-1 "\ C ) ,-.~~ AsKaOr'sPropeny Tu ParceB Number/Aecolllot Numlber: :a73*2Q.IOO ;;,17 J . I THIS MITIGATION AGREEMENT ("Agreement") is made this21.~ m.A.-V ,lOOS, between the YELM COMMUNITY SCHOOLS DISTRICT NO 2, Velm, WliShington (tlle "District") and Landshapes Norhtwest, Inc.. (the "Developer"). RECITALS A. The Developer has submitted an application to Thurswn: County for the construction of a 24 lot subdivision "Autumn Hill II" Yelrn, Wash. (the "Project"). The Project is located on property that lies within District boundaries, more particularly described on Exhibit A, attacbed hereto and incorporated herein by reference. B. The State Environmental Policy Act. Chapter 43.2IC RCW ("SEPA"), provides processes and procedures whereby major actions by SUlte and local agencies, including, but not limited to, plat or PUD approval or the issuance of building permits., may be reviewed to determine the nature and extent of their impact on the environment Impacts on public services. including schools, are environmental nnpacts for the purposes of SEP A. SEP A requires the mItigation of adverse environmental impacts. C. The District's student population i/ffid growth projections indicate that the Project WIll have an impact On the District, when cumulative impacts of other projects are considered. D RCW 82.02.020 authorizes the District to enter into a voluntary agreement with the Developer for payment to mitigate the impact ofine Developer's Project., o o E. Pursuant to Resolution No. 12-16-93-05, It is the polic)'fofthe District 10 recommend that the direct impact of development be voluntarily mitigated by the payment of fees and/or other mtUgatlon measures where appropnate. f The Developer has agreed to mitigate, on a voluntary, basis, the adverse impact of the Project on the District. AGREEMENT NOW, THEREFO~ in consideration of the above recita16 and the mutual promises and covenants below, tbe District and the Developer agree as follows: I The DevelDper acknowledges and agrees that there is 81 direct impact on the District as a result of the Developer's Project and that this Agreement is necessary 8518 result of mat impact. 2. The Developer acknowledges and agrees that in order tb mitigate the direct impact of the Project, the Developer has offered to pay the Dlstnct tbe following sum of money: Two Thousand One Hundred Forty and noli 00 Dollars ($2140.00 for each lot In the subdivision or the total sum ofFifty One Thousand Three Hundred Sh...ty and nollOO Dollars ($51,360.00) (she t'Mitigation Payment") for the 24 lots of the subdivision. The- amount referenced by tJlis paragraph is subject to change pursuant to paragraph 4 below 3 Any extension, renewal, modificatIOn or amendment ito the Project that results 10 an adjustment in the number of lots shall result m a correspondang pro tata adjustment in the Mitigation Payment, 4 The Developer agrees that the payment of the full Mitigation Payment (in the amount of Two Thousand One Hundred Forty and nolloo Dollars ($2,140.00)1 per dwelling unit or Fifty One Thousand Three Hundred Si>.."t)f and nollOO Dollars ($51,360.00) for ~e project, shall be a condition of building permit issuance for each single family dwelling in the projecti If building pennit issuance does not occur within five (5) years from the date of this Agreement, the ~ount due for mitigation, as stated in paragraph 2 above, shaU be modified to the amount reflected in i the then most recent mitigation agreement to which the District is a party A copy of such agreement shall be made available to De\lcloper upon request. : 5 The District agrees to record this Agreement after it basr been executed by the parties. 6. The Developer acknowledges and agrees that the Mitig~tioJ\ Payment IS authon.zed 10 be used for capital improvements to the following facilities: Southworth Elementary School. Mill Pond Intermediate School, Yelm Middle School, and/or Yelm High School aiJdlor any other facilities that mllY be affected by the Project and/or the purchase of portable facilities and/or school buses. 7 The Developer agrees that the District has five (5) yearli from the payment date to spend tbe Mitigation Payment for the capital improvements or expenditures kJescribed in paragraph 6. 1n the event that the Mitigation Payment is not expended within those five years, the moneys win be refunded with interest at the rate applied to Judgments to the property owners of record at the time of refund; however, if the MItigation Payment IS not expended within five years due to delay which IS attributable to the Developer, the Payment shall be refunded Without interest. 8. The Developer waives and relinquishes its right to protest or challenge the payment of the Mitigation Payment pursuant to this Agreement and hereby covenapts and undertakes that it forever refrains snd desists from instituting. asserting, filing or bringing any lawsuit, litigation, claim, or challenge or proceeding to challenge this Agreement, claim any repayment or reimbursement of funds, perfonnance or improvements provided for therem, or any of its terms and conditions, on any ground or basis whatsoever. 9 The District hereby waives any objection to the Project as presently proposed. 10. The District and the Developer agree that the Mitigation Payment will be full and complete mitigation for me impact of the Project as presently proposed Gill the District. ,11 TIns Agreement shall be bmding upon and Inure to title benefit of me heirs, executors, sdnllnJstrators, successors. and assigns of both of the Developer and thelDistrict. '> o /\ (0 12. Df an action must be brought to enforce the terms of thiS Agreement, such action shaH be brought ill Thurston CouolY Superior Court. The prevailing party shall be entitled to payment of its costs and reasonable attorneys' fees. 13 This Agreement constitutes the entire agreement betiween the parties and any other agreement either wrinen or orml shall be null and void. EXHIBIT A f)::J p LEGAL DESCRIPTION IDi31 General Location-19Y4':;'. Vancil Rd.. Yelm. WA Section 30 Township 17N Range 2E Land Area 5_94 acres Tax Parcel Number- 227;94:9HHr ~1301 30,00 ~: Description: Subdivision of 5.94 acres lOt in Ie famil buildin 10t&.. ~ YELM COMMUNITY SCHOOLS DlSTRJCT N Lh""" G~ DATED' !) - , 7~ 0 r By' Alan Burke Its Superintendent STATE OF W ASHINGTQN ) )SS COUNTY Of THURSTON ) I certifY that I know or have satISfactory evidence that AJan Burke is the person who appeared before me. and said person acknowledged mat he signed this instrument. on oath stated that he was authorized to execute the instrument and acknowledged it liS the Superintendent of the Yelm Community Schools District No.2 to be the free and voluntary ~ct of suc:h party for the uses and purposes mentioned in the instrument. I.k_ GIVEN under my hand! and official seal this ,.,.., day of 2005 ...", '" ,..., -" Q ""J:}>...... ~eNSA "~ill ,,:-J!' ^" f; ............Q<f:.r. 'I, _"'F ~I:~"'r" ;,.u D"." I ~ "","I .'. " :\uw- . 'Z. ' t _0, ; 0 ~ ~- ~... ,0 :....' if.... g w- :CJ; ~ 0 . _\'f6 ~. <- .. " ~ .0 "'- (). ~ : .... f!l" ,... - ~e" ..... 6- ~,.., c;; .}' we if ..D'h..... ~~ _- '"/,,JlTE Of .............. '\h.\.",,,,,,,' I 0 LJ In and for the State of s ington. residing at Ve/rn My Commission Expires' b-/1-L:6 ~ o DATED- ~hp> STATE Of WASHINGTON ) )SS COUNTY OF THURSTON ) C) ~~- --- . John Lubbesmtyer ~ Its !//?C"... ;~//J~ I certify that I know or have satisfactory evidence that Johnl Luobesmeyer is the person who appeared before me. ifUId slud person acknowledged that he signed thisiinstrument. on oath S1latoo lbt he was 8uthonzed to execute the instrument and acknowledged it as the applicant for this subdivision to be the free and voiunuvy act of such party for the uses and P1!l1IDSE:S mentiOned In the Instrument. GWEN under my hand llod official seal this ~ay of ' 2005 <>'/ll"","""'ll"""., -. ,.eP sTEAV, UiD~ .:- f!, ~'"......... ~Q a., J? ~.j;PN ~..~'\ i~ O:t~Y~" ~ ::11 ~ , ; ~ :0,. : Z :: \0 o.~'\,C: 0 :: . ....~v 010.. .. rv ~ .0 0 .,. "..'-.. ""_4'l).C..,' ~ ,j ~ ~..:..-,- #" -::' - ...tC9 ..... OF "8'F."""_...- _# N for the State of ngtoo. ~siding at VdrY/ My Commis$l~n Expires:' 1,0 - 1 q -o?? TOTAL P 06 / I / o o -~''''~--...~ '-'- - ~,~,.=.~:':.:-:::,- _.- '- ,~:"-~"~:='::~'~,=,.-=-~_:-'- ~ -- -" ......----.~ '-'~', - . REGISTERED AS PROVIDED BY LAW AS {JONSTgpNT GENERAL .'REG~ST # .. E.xP D~''J!li: rANQ$NT9 6SMT08/ 13/2'0'0,6 ~Ti[ VE 1;)]J\'I'lS ClE3/13 /2004: LANDSHA.PE$t{()R,TJIW~S47.,.. .J:NC: 1151 EAST 112.TH STREET TACOMA WA 9$445 I Signature . j ~~d by DEPARTMENT OF LABOR AND INDUST~ Ffi2S-052-000 (8/97) ,------ Detach And Disph1\' Certltlcate -~----. .-... =~=-=:-~_r:-" -':--''::..:,,='_"':====":'='-=:C._L Please Remove And SIgn IdenllficatIOn Card Before PlaCIng In Billfold n PIERCE COUNTY DEVELOPMENT CENTER LJ\M{))HAW-5 \\\OR" ~H\\f:.~T ApphcatlOn No PLEASE COMPLETE THE FOLLOWING: o i lP'),l \ BI r ~/ctnd ~i-~ 2002 WA. STATE ENERGY CODE INFORMATION Date Glazing area calculatIon., C Ir, -3 Heat qstem sizing calculation. 300COO btu's 2515 5 sf + \ \~y sf = % = \ ' fl.L~ X 20 J Window area + Heated floor area = % of glazing Heated floor area x btu per sq ft. = total system output Refer to the table below to determine your compliance path. Divide the system output by the equipment efficiency rating to detennine the total Btu input allowed. JOB TYPE OCCUPANCY COlVIPLIANCE PATH. flEA T SYSTEM SIZE&) J><rNew 1><rSmgle Family ~'pre6Dtive Ch, 6 (circle one) [.:>1 Btu mput l.{~ % [ ] Remodel [ ] MultI-family I dI III EffiCIency rating [ ] Addition [ ] Component Performance Ch. 5 [ ] WATTS [ ) System analysIs Ch.4 HSPF rating FUEL TYPE. HEAT TYPE. ELEC UTILITY PROVIDER. [ ] Electric 1>4 Forced Air Furnace [ ] Tacoma City LIght l><l Nat. Gas [ ] Heat Pump [ ] Puget Sound Energy [ ] Propane [ ] RadIant Heat System (baseboard, wall cadet [ ] Pemnsula Power [ ] Oil, wood [ ] Hydronics system MOther [ ] Gas or Wood Stove VENTILATION INDOOR AIR QUALITY (VIAQ) INFORMATION (check one) VentIlatIOn OptlOn. [ ]A [ ]B t><l C [ ]D [ ] AAHX System SIze 100 cfm L)(j Intermittently operating [ ] Continuous operatmg PRESCRIPTIVE REQUIREMENTSo,J FOR GROUP R OCCUPANCY CLIMATE ZONE 1- ALL FUEL TYPES Option Glazing GlaiingU-fa.ttor Door 9 Ceiling:! Vaulted Wall . '" Wall;ext, '" FlOor 5 Slab Wall; fit Area' 10 V"value ceiling 3 Abo.ve.12 .below below grade "'. 'on. %offIoor grade gtade grade vertical Overhead 1. 12% 035 0.58 0.20 R"38 R"30 R~t5 R~I'5 R40 R~30 R-TO II. · 15% 040 0,58 020 R"38 R"30 R-21 R"21 'RclO R~30 R.lO Ill. Unlirhited 040 0.58 0:20 R~38 R-30 R~2.1 Re2I R-lO. R-30 RQO GroupR"3 OcciJpancy OWy · Reference Case o Nominal R-values are for wood frame assemblies only or assemblies built in accordance with Section 601 I I Minimum requirements for each option listed. For example, if a proposed design has a glazing ratio to the conditioned floor area of 13%, it shall comply with all of the requirements of the 15% glazing option (or higher). Proposed designs which cannot meet the specific requirements of a listed option above may calculate compliance by Chapters 4 or 5 of the W.S.E.C 2. Requirement applies to all ceilings except single rafter or joist vaulted ceilings. 3 Requirement applicable to only to single rafter or joist vaulted ceilings. 4 Below grade walls shall be insulated either 011 the eJ\1erior to a minimum level of R-lO or on the interior to the same level as walls above grade. Exterior insulation installed on below grade walls shall be a water resistant material, manufactured for its intended use, and installed according to the manufacturers specifications. 5 Floors over crawl spaces or exposed to ambient air conditions. 6. Required slab perimeter insulation shall be a water resistant material, manufacftured for its intended use, and installed according to manufacturer's specifications. 7 Int. denotes standard framing 16 inches on center with headers insulated with a minimum ofR-5 insulation. 9 Doors, including al fIre doors, shall be assigned default U-factors from Table 10-6C 10 Where a maximum glazing area is listed, the total glazing area (combined vertical plus overhead) as a percent of gross conditioned floor area shall be less than or equal to that value. Overhead glazing with a V-factor of U=() 40 or less is not included in glazing area limitations. II Overhead glazing shall have U-factors determined in accordance with NFRC 100 or as specified in Section 502.1.5 12. Log and solid timber walls with a minimum average log thickness of 3.5 inches are exempt from this insulation requirement. CITY OF YElM R.ES!DENTIAl BUILDING PERMIT APPUCA TION FORM Project Address: ~~.' Sf: parce,#'1.~"T~O\?D'lO~"-;; "'>~ived Subdivision ~'\~tt\rnn Ihll.1T lot #. 5 Zoning; Jl: 4 l005 ,Cy New Construction 0 Re-Model / Re-Roof / Addition 0 Home Occupation Sign o Plumbing 0 Mechanical 0 Mobile / Manufactured Home Placement 0 Other Project Description/Scope of Work. c')\ f\{~\t:_ -\1\ \ ") ) \ II:J Project Value: Building Area (sq. ft) 1st Floor iLl I <0 2nd Floor SoLo Garage 1j(;2- o o Deck 15{p # Bedrooms0 Basement # Bathrooms '2 - 5 Carport Patio ~-~. Heating <?~THER or ELECTRIC (Circle One) Are there any environmentally sensitive areas located on the parcel? completed environmental checklist must accompany permit application . BUILDING OWNER NAME LI\\(jr)',\-~f\\:>t~":::. \~('\\C\\.\V\lI::-~(:::)-r. \\\)C ADDRESS \ Fj\ E l O-\\<-! ":~=) f EMAIL. CITY.JJJ.LhY\(\ STATE hi!\' zIP~l.bl;\Lj~::) TELEPHONE 'J};):",/~:7::S1-{r~a 0 If yes, a ARCHITECT/ENGINEER 1 JE<-} i {)I\.:, '';EJ<'d If E:c,) LICENSE # ADDRESS ti>02(-) 1\ Ljli{f::FT . . EMAIL CITY~.)tnH STATE ~\i'A ZIPq"~4Y2'. TELEPHONE2-S3/'-#75 \~Ii.:Y:d.:' GENERAL CQ~.TRAfTOR LC\\<~\),)\H\\)r:~ N~\I TELEPHONE !2~'Y~1 ;;:Y3>'1-{ (.);~(IO ADDRESS Ii lb\ E \ \2. \-1'1 5-1" . . EMAIL CITY ni\\)rYlfi STATEV\{f) ZIP q'nf.-ILI~:) FAX 2"'j';~r"j~.~.->> Lj lit?.:; CONTRACTOR'S LICENSE # Lt\~nSNx:tltoSlniEXP DATE CIT LICENSE # PLUMBINc;~C,ON.TRACJ.O!3 el2:)~f:<)S!\)!\\i L '\ lUII)f:ii\~ELEPHONE '):::, ,?)L - _. 3 ADDRESS Pi) P:l0X ~~.,::; EMAIL CITYC}\,,{f\Hf~tr) I STATE ~\if\ ZIPClv,,?=?>.h FAX CONTRACTOR'S liCENSE #PR(\fE.~S5e.o. EXP DATE CITY LICENSE # MECHANIC6'L CONTRACTOR HiI\/lE \-IEiflli\K:l TELEPHONE 'lb 0J Clf-n - q Oq 5 ADDRESS 2Y7 Cy'.j.) 2:;~l'n H \i 1:: r:; EMAIL CITY~'))l\\~'\\I\ln'l STATE ~\{f\ ZIP (w)~)i'n FAX '15),;'/ "f;'-i1-Q.-')1~~ CONTgACTOR'S LICENSE # R\\.t\H\ Ul\-\{) \r.') Ct.. EXP DATE c(TY LICENSE # J Copy of mitigation agreement with Yelm Community Schools, if applicable I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above described property will be in accordance with the laws, rules and regulations of the State of Washington and the c"y(~ - Applic \\~() \ \ \\:L \ rVlnvv\ C I - owne~\.\!..b.L.LQ~~ ~li~~i~-~W\Jffib6n ble(~ ljJn~till:1005 w.t.\k.EWlJS / 1715 Ye. M ,ng 1\ -h '/\ if) / ~~~~. ^: -l-t' - "f":~V.L\_~ ) _~. .Y_kJD.tnse.. ' p-rOf:fS~ I Jlt~\ ~ tfrn-bf\ ~()JI j / LOT =\t: 5 (t) PJaX1S ~:::un t2)~ 35 44 FAX t.wa.us