BLD-05-0183
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CITY OF YELM - BUILDING DEPARTMENT
RESIDENTIAL CERTIFICATE OF OCCUPANCY
Building Address
15722 Yelm Terra Way SE
Owner Name
Owner Address
Everqreen State Builders
P,O. Box 39753
Lakewood WA 98499
Building Permit Number
BLD-05-0183- YL
Plan Number
Plan 1740/3B Lot 84
Remarks
Areas Inspected
All Code required
Special Conditions
Building Official
G, Carlson
Date
March 8, 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 7092 RCW, effective July 1, 2004
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FROM YELM SEWER DEPT
FRX NO 360-458-8166
Feb 28 2006 02 06PM Pi
FAX TRANSMISSION
CITY OF YELM
P.o. BOX 479 - 931 NP ROAD NE
YELM, W A 98597
(\ \) 360-458-8411
\)~\ FAX 360-458-8166
TO: & (c ?<.~/6t0 DA IE: .;1-.::L &0 Ie,
FAX#:
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Cover sheet
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Subject: l+o l.A S' E" P /;Jf11 '1'15 L Yr-, l1:::;~ (<'A
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++ If you do not receive all copies or any copy is not legible, please call (360) 458~8411
as soon as possible.
CITY OF YELM INSPECTION LOG
C PROJECT? /0/10 ~~/ /} 10 + 2 L/
PER.~1lT NU!\1BER 0 ~ - 0 ) 83
".OORESS / 57;;d- Ye:.tw. MrN1 {{Jay Sf ~
SET BAChS Date FOOTfNG
Front 18. CJ 1 2"'
Rear 7JifiP 0 16"
Side FlaMing ~. 7 :J other
SIde ~ 0 reqUired, ents
FOOTl'\GREB\R / 0,,< J..CI~\\'\ll REBAR
WALL
Q 6"
o 8"
o other
Date
CO!11!T!ents
CO\lBI;\[D FR-\~lE/ L\. TERIOR SHEAR W .\LL I\SPECTIO~
Hold downs :J J4; Shear NaIlIng -
Frame 11 II-oS ,'Gas'Propane 30 1!-c1r
Plumbing ~ W c!!l I;; Mechanical ]I 11- (15"
#
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C Comments
I'\Sl LA TIO"-'
J Gas
f11' F 03m and Seal
~ Electflc
~ \' apor b3ITler
'1 Other
~ PV-\
Comments
SHEET ROCK/SHEAR \V -\LL '\ -\IL
Comments
OTHER
Comments
FI,,-,AL
o Se\\ er Final
:J Address
Q Electrical
!J Insul3tlon
Q C1\IlFmal CJ bndscare Fm::d iJ ((If 0
o SIte Drainage 'I Slde\\ all-.
Comments
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0183-YL
Issue Date 09/19/2005
(Work must be started within 180 days)
Receipt No
38267
Applicant:
Name Evergreen State Builders
Phone:
253.475.6622
Address, P.O Box 39753
City' Lakewood
State: WA Zip 98499
Property Information:
Site Address. 15722 Yelm Terra Way SE
Assessor Parcel No, 85840008400
Subdivision, Yelm Terra
Lot: 84
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 1740/3B Lot 84
Sq. Ft per floor (1st) 1172 (2nd) 1028 (3rd) 0 Garage 480 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 1,14775 993,75 154 00 5 6000 27 5000 $1,000
Building Plan Review 485.51 000 000 o 0000 o 0000
Mechanical Permit 78.75 000 000 o 0000 0.0000
Plumbing Permit 111 00 2000 9100 7 0000 13.0000 Fixture
Sewer Inspection 14500 0.00 145 00 145.0000 1 0000 ERU
Water ERU 1,50000 000 1,500.00 1,5000000 1 0000 ERU
Water Meter (SFD) 300 00 300 00 0.00 o 0000 o 0000
Water Deposit 40.00 4000 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 000 0.0000 0,0000
State Building Fee 450 450 000 o 0000 0.0000
Sewer ERU 5,41700 000 5,41700 5,4170000 1 0000 ERU
TOTAL FEES. $10,037.01
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,
# Sets of Prints.
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Signature A'" ~ =- -
Firm IIIIJ!!I"s 4
Date ~/':'4AS
.,
Final Inspection:
Date: 3-?-0 V
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RECEIPT No.3 8266
REG~IVJ;PEN THi=JtJ~ld'1[ Tl'l~ H1Jt~r:q:I-~r FTE'Tl PI.iS [' ~iLr_~;\P;: /:i
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RECEIVED FROM
DATE
REC. NO.
AMOUNT
REF NO.
SJEFG~EEN STATE EUILDEF:
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Yelm Community Scn~~
PO Box 476 "-~ ~_
Ye 1 m I WA 98597 ___________
Clerk:
Terminal
Recei~t:
Manua 1 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
Amount Due
8555.00
0.00
8555 00
8555,00
0,00
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08/08/2005 17 00
2532843183
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CAS RES NO Tm1
LOT 84
EVERGREEN STATE BUILDERS
YELM TERRA
15722 YELM TERRA WAY SOUTHEAST
YELM, WA
SITE PLAN APPROVAL
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AND RE:UASLC ANY DISC~Er^fI:CI:S D[lW[[N nHS C~A.WI~JG ^"D TI-l~ ACTUA:" SiTE CO~:llji::~S
f\RC '!\~E SCl~ R(!;rON~lg\U''f o~ iH':: curNT
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Project Addra6s: I~, ,..c::;)A "'t.M. -r~a..A. wA-t $1. Parcel #i~_
Subdivilllon;~J.e( C~ lol N ~" Zoning; ,,$-0~e ;:;t!:!1J.i 'j
~ew Construdion U Re-Modell Rtt-.Roof I Addition u Home Occupatitln Sign
u Plumbing u Mechanlcol U MobIle I Mar~uf\iJctuY'ed Home PllWement u Other
Project Description/Scope of work:_~~le. -{l.(A'!lt ~fj f~ rs,( dlhJll qd__
Project Value: :2-'3>'-\ I q ~(:) ._______ .
Building Area (sQ ft) 1 ~l F loar ~ till Floor. '15"<-::_ Garage L\ l 'b ~ Deck
Basement Carpol1___.,_._Patio L(, ~~
# Bedrooms2-, # 8athrooma.~.5 H0aUn~THER or ELECTRIC (Circle One)
Are there any tJH1vitOtll'l'1entally sansitivEl araaslocatad on the parcel'? _~__ If yes, Ii
completed anvironmuntal checklist must accompany permit application
aUlli)lNG OWNER NAME~'-- t--'<!i~~, ~f!j:;1el::r(j/UrJLS ~ . ~.
ADDRESS ~15i.;'L::'. /{)(')l.' tl' r ""' 1.t.~.tZtL_EMAll L-'\.~~ - 'C,;"2u~]JJl~jI..
errv ~~TATE.. . lIP.qjY.2l-n:U~::PHONE" '~'. _-,~.;, "Z ,
r ARCHrrEC"IENGINEEii7W~#l~ICE.NSE i(__ - . . ~
AODRESS~;....~_~~~~ . ~EMAIR.aw.~ ___
crrv:];(tf!!r~=SlATE~?!"~~~~lEPHot~iEi~,)31 "2ICfli/'7.!l.
GENERAL CONTRAC'TOR.~.$77.ltiiL(?r TELEPHONE____ -----"=:----J
ADDRESS___.__.___._ __EMAIL __ ~ ~
CITY ~.nArE ZIP FAX
C(JlIiffiiiCTOR'SLl(~~~~EX~~~iYiJCENSE~~:": ....
PWMBING Cl)N~. JOR4~~~)N;;frELEPHONE/~-;3'7-fi:.?J 2' 'J
~?~R1!~j~F-- S~r aJT--zIP 98S1t.'?~~~~~~S:i ~~~=9~ --=
CONTRACTOR'S ',.ICENSE # EXP DATE CITY LICENSE #
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MECHANICAl CONTRACTOR~.&.tL~7 :rE'l.'F.:PHONE M3 - Lz~J;{[tJ_
ADORESS~~~~ _____.EMAIL ._____.__._ ..
CITY,~~___STATE~A _liP .2!L.LZ~ .FAX_~_,__________
CONTRACTOR'S LICENSE ## ./.'iJ1O"" y~_ EX., OA TE...",__..CITV LICENSE # _~_, ,
... ._~..w_~,.....~",,,,,,,,, ..__...._~.....--.......
Copy of mitigatIon agreemt:mt with YeJm Cort'H"I'lurlity Sehoola, if appHeabJe
I /lul1lb . rtlfy Ihullh. otlOYII 11!1t1rml'lUon Is l~I(JYr"lH:t and thot thll CUr&strUllUun on, and the occupancy sncllhe use at the
bboVfI d 'rfbed pl'tlpel1y will be Irl alllmmhmCIl with the lawII, ,ulullilnd f~gl\lllltl<<ln8 of the 8t1l1te of W8shlflgtllll and the
City of Ve 1
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Applicant" atUl'''~_"''''''''''''''-'''--'- Date
Owner I ContrDctor(~l.r'B A~!!J!l Contractor's Agln' (Pleas. elrel, one.)
All permits are non~tranlSfer~ble and wU! oxplre If work l!Iuthmb:ed by such permit II nat begun
within 180 daye of It<lISUI!lrIte, ot if wurk II $ulllpend~d or abandoned fov' a period of 180 dliy&
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1"0 BoJt 4'19 (360) .fS84i44 FAX
'VI/1m, WA DB59? www.tJi.).tll1n.wa.Wl