BLD-05-0187
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CITY OF YELM - BUILDING DEPARTMENT
RESIDENTIAL CERTIFICATE OF OCCUPANCY
Building Address
10462 Yelm Terra Street SE
EverQreen State Builders
P.O. Box 39753
Lakewood WA. 98499
Owner Name
Owner Address
Building Permit Number
BLD-05-0187-YL
Plan Number
Plan 2170/2 Lot 80
Remarks.
Areas Inspected
All Code required
Special Conditions
Building Official
G. Carlson
Date
March 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 19 27 and 70 92 RCW, effective July 1, 2004
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FROM YELM SEWER DEPT
FAX NO 360-458-8166
Feb 27 2006 12 43PM Pi
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FAX TRANSMISSION
CITY OF YELM
P.O. BOX 479 -931 NP ROAD NE
YBLM, W A 98597
{\_ D\} 360-458-8411
\J A \'\ J FAX 360-458-8166
TO: (7 {l~ H tS\J DA TE: ::>.. - ;J. -J - D ("
FAX#:
PAGES: , , including this
Cover sheet
From: KA-D DY
Subject: Ho u 51.:: F \.J A L/ 'Te: L""- ~ti'M
COMMENTS: LoT <6-01' 0 Lf 0;).. Y E" Lm TG"fz-tU] 57, S. E"
(y5 ~5o/)O .00
u If you do not receive all copies or any copy IS not legible, please call (360) 458-8411
aR soon as possible.
CITY OF YELM INSPECTION LOG
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PROJECT W- <790 'i~. /~r~
PER-t\,11T NU!\1BER /:)';- - D)~ 1
ADDRESS 1.0'-}loZ- Yt:V-.- /Zr~ .511, S{;"
SET BAChS Date FOOTING
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Rear:32-- J1' 16
Side Flanllng "7 Q other
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Plumbing =:J Mechamcal :J
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Comments
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Comments
OTHER
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'I Side" al"-
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0187-YL
Issue Date. 09/19/2005
(Work must be started within 180 days)
Receipt No
38266
Applicant:
Name: Evergreen State Builders
Phone.
253-475-6622
Address. P.O. Box 39753
City. Lakewood
State: WA Zip 98499
Property Information:
Site Address. 10462 Yelm Terra Street SE
Assessor Parcel No. 85840008000
Subdivision. Yelm Terra
Lot: 80
Contractor Information
Name: Evergreen State Builders
Contact: McCullem, Tom
Phone. 253-475-6622
Address. P.O. Box 39753
City' Lakewood
State: WA Zip: 98499
Contractor License No: EVERGSB980PB
Expires. 10/02/06275
Business License. 1042.0
Project Information:
Project: Yelm Terra
Description of Work: Plan 2170/2, Lot 80
Sq Ft. per floor' (1st) 1363
(2nd) 658
(3rd) 0
Garage 440
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 1,282.71 993.75 288.96 5 6000 51 6000 $1,000
Building Plan Review 542.02 0.00 000 o 0000 0.0000
Mechanical Permit 8475 000 000 o 0000 0.0000
Plumbing Permit 132.00 2000 112.00 7 0000 160000 Fixture
Sewer Inspection 145.00 000 145.00 145 0000 1 0000 ERU
Water ERU 1,50000 0.00 1 500 00 1,5000000 1 0000 ERU
Water Meter (SFD) 300 00 300 00 0.00 0.0000 o 0000
Water Deposit 4000 4000 000 o 0000 0.0000
Traffic Facilities Charge 757.50 0.00 757 50 750 0000 1 0100 Peak PM Trip
Sewer Deposit 5000 5000 0.00 o 0000 0.0000
State Building Fee 4.50 450 0.00 0.0000 o 0000
Sewer ERU 5,41700 0.00 5,417 00 5,4170000 1 0000 ERU
TOTAL FEES. $10,255.48
Applicant's Affadavit:
OFFICIAL USE ONLY
I certify that I have read and examined the information contained within the application and know the same
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regulations including those governing zoning and land subdivision, and in addition, all covenants,
easements and restrictions of record. If applying as a contractor, I futher certify that I am currently
registered in the State of Washington.
Signature/~- Date "'/IfJ-~
Firm ,,$ 4.
# Sets of Prints.
Final Inspection:
3-Jl/~tJ0
4f!fl-
Date:
By'
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~THE~~ CITY OF
! r. YELM
~ PO Box 479
Yelm, WA 98597
.."YE!:-.~o.~ 360-458-8403
RECEIPT No.3 8 266
REQ~IY!:=PEm T' Hi _! L ,~ c, HI:
T~1: HU~~~}FSr FIFTY F~.\rE [lJLLARI:
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RECEIVED FROM
DATE
REC. NO.
AMOUNT
REF NO.
2JEFG~EEN STATE EUILrrF2
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~ PO Box 479
Yelm, WA 98597
"._YE!-'~.,"N 360-458-8403
RECEIPT No.3 8 267
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Yelm Community sc~p~
PO Box 4 76 ~ . -------------~
Yelm, WA 98597 _______
Clerk'
Terminal
Recei~t,
Manual Receipt:
Croy
1
3652
EVERGREEN
DISTRICT OFFICE
EVERGREEN STATE, BUILDING LLC
9/19/2005 9'06 AM
Qty Item
Price
1 CPF2900 8555 00
MITIGA nON
YELM TERRA DEVELOPMENT - LOTS 38,64,80,84,
88
Subtotal,
Tax
Total
Check
10393
8555,00
o 00
8555 00
8555,00
Amount Due,
0,00
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Project Address:/e' 7'6 L ~/~ R............, $7::" ~I #" 2/ 7CJ/~ . <:~'"
Subdivision: ye( WI. t:ef- {~ lot #. $' 0 Zoning; .&U gle -fM?1, /'J~'-
~ew Construction U Re-Modell Re-Roof I Addition U Home Occupation Sign
U Plumbing U Mechanical U Mobile I Manufactured Home Placement U Other
Project Description/Scope of Work:~ ~ Ie. -raM I '.3 ff. &t duJ I cr..../
Project Value. Z:Z ~ ~ <""""l>
Building Area (sq. ft) 1st FIOOr-4763 2nd Floor 7'7 Garage ~9'o Deck
Basem~nt Carport Patio.,2/ b
# Bedrooms .3 # BatA~06ms 2..0- Heatin~OTHER or ELECTRIC (Circle One)
Are there any environmentalli sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
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ARCHI1ECTIENG1NEER.~:S"~ =/f/UCENSE #
ADDRESS hl ~;;Z 'Yf.cS EMAILarJt1~
CITY72lCiJrfla STATE:&'.f/I ZIP <;1x~z TELEPHONE{-!:S'"i/ 2lf'l-t3/76
GENERAL CONTRACTOR \~ a,s (JUIJUr TELEPHONE
ADDRESS EMAIL
CITY STATE FAX
CONTRACTOR'S LICENSE # e~ EXP OAT (I.l CITY LICENSE #
PLUMBING CONTR&;rOR-l
ADORES~~ -<-f1~
CITY /2l It STATE
CONTRACTOR'S LICENSE #
ZIP
TELEPHONE
EMAIL
FAX Z<-.~~-q?~
EXP OA TE CITY LICENSE #
MECHANICAL CONTHACT9R .~H~r/ #e:A'T7 .#'7 TELEPHONE Z5'..; S 7.s-~ .? J.:f'CJ
AODRESS5SzG'. /..:"'~"- 5r ~;-M A. EMAIL
CITY h;',I"c?#F?S STATE /--- '7- ZIP ?~.? 7S- FAX %5'3 ,.#' 7.5'- P' z.fS-
CONTRACTO 'S LICENSE # EXP OA TE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable
I hereby cerUfy thaI the above InfOl'matlon 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
City of Yelm.
/~~ _ ~/7-,!PS-
Applicant's Signatun~ Date
Owner I contractor(~ Contractor's Agent (Please circle one.)
All permits are non-transferable and will expire if work authorized by such permit is not begun
within 180 days of is!;uance, or if work is suspended or abandoned for a period of 180 days
105 Yelm Avenue We81
POBox 479
Yelm. WA 98597
(360) 458-3835
(360) 458-3144 FAX
www.ci.yelm.wo.us
o LOT 80 0
EVERGREEN STATE BUII-ADERS
YELM TERRA
10462 YELM TERRA STREET SOUTHEAST
YELM, WA
60 00'
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. SITE PLAN
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@ 2005 CASCADE RESIDENTIAL Dr-SIGN, INC
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NORTH
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