BLD-05-0182
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CITY OF YELM - BUILDING DEPARTMENT
RESIDENTIAL CERTIFICATE OF OCCUPANCY
Building Address
10468 Yelm Terra S1. SE
EverQreen State Builders
P.O. Box 39753
Lakewood WA. 98499
Owner Name
Owner Address
Building Permit Number
BLD-05-0182- YL
Plan Number
Plan 2200/2 Lot 81
Remarks
Areas Inspected
All Code required
Special Conditions
Building Official
G. Carlson
Date
February 21,2006
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 1927 and 7092 RCW, effective July 1, 2004
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FROM YELM SEWER DEPT
FAX NO 360-458-8166
Feb. 17 2006 04 54PM P1
FAX TRANSMISSION
~~~
CITY OF YELM
P.O. BOX 479 ~ 931 NP ROAD NE
YELM, W A 98597
360-458-8411
FAX 360-458...8166
DATE: d.: 17~o C:,
FAX#:
PAGES: I, including this
Cover sheet
From' RAAJOY
Subject: \40 LA.s~ F \,0 A LS I 'Y'ETyY, IElLrcA
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'ft'l' 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
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PROJECT
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PER.~llT NUMBER 0:; - () / <:g c2
ADDRESS /64(r? 2:? Ve! VYl ~('C{
Lot
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Front
Rear
SIde Flam.lng
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FOOTING
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~ 16"'
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WALL
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Hold downs ::J Shear NaI1ln~
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Plumbing ~ ~1echamcal ~
C Comments
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~ Gas
'-.Q Foam and Seal
CJ ElectriC
~ Vapor baITler
., Other
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Comments
SHEET ROCKJSHE.-\R \\' -\LL '\ -\IL
Comments
OTHER
Comments
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'B Se\\ er Final Q Eleclncal
:J ~ddress ~ Insubtlon
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No.
BLD-05-0182-YL
Issue Date 08/22/2005
(Work must be started within 180 days)
Receipt No
38053
Applicant:
Name. Evergreen State Builders
Phone.
253.475.6622
Address. P.O Box 39753
City' Lakewood
State. WA Zip 98499
Property Information:
Site Address 10468 Yelm Terra St SE
Assessor Parcel No. 85840008100
Subdivision: Yelm Terra
Lot: 81
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 10/02/06275
Business License. 1042.0
Project Information.
Project: Yelm Terra
Description of Work: Plan 2200 /2 Lot 81
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 1,30119 993.75 307 44 5.6000 54.9000 $1,000
Building Plan Review 549 75 000 000 o 0000 o 0000
Mechanical Permit 8475 000 000 o 0000 o 0000
Plumbing Permit 118.00 20.00 98.00 7 0000 14 0000 Fixture
Sewer Inspection 145.00 000 14500 145.0000 1 0000 ERU
Water ERU 1,500 00 000 1,500 00 1,5000000 1 0000 ERU
Water Meter (SFD) 300 00 300 00 0.00 o 0000 0.0000
Water Deposit 4000 4000 000 0.0000 o 0000
Traffic Facilities Charge 757.50 000 757.50 750 0000 1 0100 Peak PM Trip
Sewer Deposit 5000 50.00 0.00 o 0000 0.0000
State Building Fee 4.50 4.50 000 0.0000 o 0000
Sewer ERU 5,41700 000 5,417 00 5,417 0000 1 0000 ERU
TOTAL FEES $10,267.69
Applicant's Affadavit:
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.
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OFFICIAL USE ONLY
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360-458-8403
RECEIPT No 38053
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YELM COMMUNITY SCHOOLS
LOCAL RECEIPT
25566
DATE ~1 00 ~.r
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FOR fj d IY1 -:75 - l a 1--5. "i5..... f? / ~
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:A5H CHEC: /0 ~2 cJ / ~.
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LOT 81
EVERGREEN STATE BUILDERS
YELM TERRA
10468 YELM TERRA STREET SOUTHEAST
YELM, WA
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WATER LINE~ =-~-~~-=I~(7I-~
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SEWER LINE ---------
CURB
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~~ SITE PLAN
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@ 2005 CASCADE RESIDENTI/lL DESIGN INC
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NORTt-I
SCALE l' = 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
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ProjectAddress:~J Y.&h- ;:;:;?~e,4 ~~#. ~aloc>/~
SUbdiViSion:Ye{rvt l--frrtfL Lot#. e:.9'/ Zoning; ~-f1~ Iii --(a1?1., Ij
~ew Construction U Re-Model J Re-Roof I Addition U Home Occupation Sign
U Plumbing U Mechanical U Mobile I Manufactured Home Placement U Other
Project DescriptionlSc:ope of Work: ~ f) If!. -F (,Uytll 0J ee ~j ~J I CL I
Project va'ue.h.J'7'; 95'0
Building Area (sq. ft) 1 sI Floor /? 7 z.. 2r.d Floor /6 Z. g Garage fig (;) Deck
Basement Carport Patio 2/ b
# Bedrooms....l. # Bath"ioomsZ -S Heatin~OTHER or ELECTRIC (Circle One)
Are there any environrnentarri sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit appJication.
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ARCHITECTIENGINEE t;- -S"
ADDRESS iJ ra ~jl' ~
CITY/aY:iil/, - STATE j;;,c./l ZIP 9l;0Jz
LICENSE #
EMAIL
TELEPHONE
GENERAl CONTRACTOR \.WIIM a S ()71IJUr TELEPHONE
ADDRESS EMAIL
CITY STATE FAX
CONTRACTOR'S LICENSE # eih EXP DAT CITY LICENSE #
ZIP
. TELEPHONE
EMAIL
FAX z(~..536-96~
EXP DATE CITY LICENSE #
PLUMBING CON, TR8(;rOR...,j
AODR~~~-~7~
CITY fa I( STATE
CONTRACTOR'S LICENSE #
MECHANICAl CONTHACT9R ,~N..t-~/ #6Arr #'7 TELEPHONE Z5.1 S 7o~? n'"a
ADORESS5Sl:G /'.J"'.y-r .:rr $....M -"'!. EMAIL
CITY &jfC#~ STATE ~___"?' liP ?~.? 75 FAX "ZS~~ ,#'7..>- #z.~.s-
CONTRACTO 'S LICENSE # EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable
, hereby certify thaI the lIbove Information 15 correct and thllt the construction on, and the occupancy and the use of the
above described property will be In accurdance with the laws, rules and regulations of the State of Washfngton and the
City of Yelm.
/~ ~ J'':/J-&~-
Applicant's S;gnatu~, Date
OWner I Contractor l~ Contractor's Agent (Please circle one.)
All permits are non-transferable and will expire if work authorized by such permit ;s not begun
within 180 days of Is!mance, or if work is suspended or abandoned for a period of 180 days
(360) 458--3835
(a~o) 458-3144 FAX
Ulww.ci.yelm.wa.us
105 Yelm Avenue West
PO &x 479
Yelm. WA 9859'1
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