BLD-05-0180
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Building permit Number
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plan '\8'\8 $12
owner Name
Owner A.ddress
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plan Number
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I\oril '\7. 2006
p.seas If\Spected
special conditions
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Building Otficiat
, ,e Inlero.tion.\ Residenti.1 Code (Coaptel
.niS stlUclule is in co",pl..nce ~'I~~n ton st.te Building Code Council pulSu.nl
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~~~~~~~~~~~~~~~ -eOMM. JOURNAL- ~~~~~~~~~~~~~~~~~~~ DATE APR-17-2006 ~~~~~ TIME 02:36 ~~~~**~~
MODE =
MEMORY TRANSMISSION
START:APR-17 02.35
END:APR-17 02:36
FILE No.=555
STN
No.
eOMM.
KEY NAME
STATION NAMEIEMAIL ADDRESS/TELEPHONE NO. PAGES
DURATION
001
OK
[evergreen state] evergreen state
001/001
00:00:26
-Yelm eDD
***~* DP-3520 ~~~**~~~~**~~~~~*~~~~~ -Yelm eDD
- *~*** -
360 458 3144- *****~~*~
CITY OF YELM INSPECTION LOG
c
PROJECT
P tCVKJ jj}JJ ) d-
PERMIT NU!\1BER () 5"' - 0 I <? 0
/0 tf ft-- M
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Lo'f 7 $
ADDRESS J S'7'?> 7
SL
SET BACI\S Date
Front ~ -z,{.../
Rear _ LJt
SldeFIank.lng .1; J f)
Side J-r" '/()
FOOTING
::J 1 2"'
o 16
~ other
o requITed \ ents
\V ALL
~ 6"
o 8"
o other
FOOTI'\G REB.\R
Date
\\' .\LL REBAR
D:ne
C 0!Tl.!T!ents
CO\lBI;,\[D FRA \lE/ EXTERIOR SHEAR \\' .\LL I\SPECTIO,,",
Hold downs :J Shear NaIling ~
Frame J Gas 'Propane :J
Plumbing :J ~1echanIcal J
C Comments
I'\Sl L.\TIO,,",
:J Gas
[] F 03m and Seal
::J ElectrIC
:::! \' apor b3rner
fI Other
...., P\'-\
Comments
SHEET ROCK/SHEAR \V .\LL \ .\IL
Comments
OTHER
Comments
FI""'AL
o Se\\ er Final
:::J Address
Q ElectrIcal
CJ Insubtlon
CJ CJ\ II FIn31
o SIte DraIn3ge
~ bndscare FInal IJ C(lfO
'I Slde\\al)"
Comments
C
FROM YELM SEWER DEPT
FAX NO 360-458-8166
Apr 10 2006 10 23AM Pi
FAX TRAN'SMISSION
CITY OF YELM
P.O. BOX 479 - 931 NP ROAD NE
YELM, W A 98597
. 360-458-8411
TO' ~~GAJ
DATE: '-j.., J D - D (p
FAX#:
PAGES: I , including this
Cover sheet
From: K'fV\JDY
S ubj ect: H 0 '"" 5 e; F ,:V It ;J '-i' l;O I.-Vll 1bl2-'f2f)
COMMENTS: .hoT 7~ /0737 )O,,!TJ;! Aut; S,~.
05,-5750 -OD
"'* If you do not receive all copies or any copy is not legible, please call (360) 458-8411
as soon as pO$!'lible
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City ofVelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0180-VL
Issue Date. 09/23/2005
(Work must be started within 180 days)
Receipt No
38324
Applicant:
Name, Evergreen State Builders
Phone:
253.475.6622
Address P.O Box 39753
City' Lakewood
State: WA Zip 98499
Property Information:
Site Address. 15737 104th Ave SE
Assessor Parcel No. 85840007500
Subdivision, Yelm Terra
Lot: 75
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 18185/2 Lot 75
Sq. Ft. per floor' (1st) 547 (2nd) 1271 (3rd) 0 Garage 585 Basement 0
Heat Type (Electric, Gas, Other): GAS
Fees.
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
--------------------------- -------------
Building Permit 1 00-50 Ok 1,17558 993.75 307 44 5.6000 54 9000 $1,000
Building Plan Review 496,68 000 000 0.0000 o 0000
Mechanical Permit 78.75 000 0.00 0.0000 o 0000
Plumbing Permit 132.00 2000 112.00 7 0000 16.0000 Fixture
Sewer Inspection 145.00 000 14500 145 0000 1 0000 ERU
Water ERU 1,50000 0.00 1,50000 1,5000000 1 0000 ERU
Water Meter (SFD) 300 00 300.00 000 o 0000 o 0000
Water Deposit 4000 4000 0.00 o 0000 o 0000
Traffic Facilities Charge 757.50 000 757.50 750.0000 1 0100 Peak PM Trip
Sewer Deposit 5000 5000 000 o 0000 0.0000
State Building Fee 450 4.50 000 o 0000 o 0000
Sewer ERU 5,41700 0.00 541700 5,417 0000 1 0000 ERU
TOTAL FEES. $10,097.01
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.
Final Inspection:
Signature ,/ ~~/ -
Firm 4$4 .
Date
~-~z.,t!'JS
'\
Date:
By.
Applicant:
o
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Address. P.O. Box 39753
Name: Evergreen State Builders
Project Information
Project: Yelm Terra
Description of Work: Plan 18185/2 Lot 75
Site Address, 15737 104th Ave 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.
PAID
o
Permit Fees Schedule
SEP 2 3 inns
C\TY OF YELM
City' Lakewood
Phone:
Permit No BLD-05-0180-YL
333~ l{
State: WA Zip 98499
253.475.6622
Assessor Parcel No, 85840007500
Item Fee Base Amt
1,175.58 993.75
496 68 000
78.75 000
132,00 2000
14500 000
1,500.00 000
300 00 300 00
4000 4000
757.50 000
5000 5000
450 4.50
5,41700 000
$10,097.01
307 44
Unit Rate No. Units Unit Desc
Unit Fee
000
5.6000 54 9000 $1,000
0.0000 0,0000
112,00
7 0000
o 0000 0 0000
0.00
145.00
145,0000
16.0000 Fixture
1 0000 ERU
1 0000 ERU
0.0000
o 0000
1 0100 Peak PM Trip
o 0000
0.0000
1 0000 ERU
1,50000 1,500.0000
000 o 0000
000 o 0000
757 50 750 0000
000 0.0000
000 0.0000
5,41700 5,4170000
Q1dir'
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RECEJ lED
RECEiPT No 38323
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REF NO
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REC NO
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m=.cEi\iED FGOivl
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CITY OF
YELM
RECEUIPT No 38 3 24
FO Box <179
)'c\n-" Vv!-\ ~'-)8~)97
'~r)OA :)8-G,t: 13
L n"
liEF NO
DATI:=.
FiEC NO
AMOUNT
C\ 'j:' 1 t [- 'I
1.j'. L
1;
HECEI'JED FROM
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Yelm Community Schools
PO Box 476
Yelm. WA 98597
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Clerk. C
Termina 1. roy
Receipt: 4'6
Manual Receipt: 94
EVERGREEN
DISTRICT OFFICE
EVERGREEN STATE, BUILDING LLC
9/23/2005 2:17 PM
Qty Item
1 CPF2900
MITIGA nON
YELM TERRA LOTS 75,78,82
Price
5133,00
Subtotal. 5133 00
Tax' o 00
Tota 1: 5133 00
Check 5133.00
10424
Amount Due, o 00
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.p.
rv
.p.
Yelm Community sc~
PO Box 476 ~--
Velm. WA 98597 ..n~
Clerk:
Terminal:
Receipt:
Manual Receipt:
Croy
1
4693
EVERGREEN
DISTRICT OFFICE
EVERGREEN STATE. BUILDING LlC
9/23/2005 2'16 PM
Qty Item
1 CPF2900
MITIGATION
YElM TERRA DEVELOPMENT
Subtotal:
Tax:
Total:
P rice
13688.00
13688,00
0.00
13688.00
Check 13688.00
10405 lOTS 6,7,9,10
,11,34,35,36
Amount Due. 0.00
09/15/2005 17 00
25?0l843183
U
CAS RES NWc==JDM
PAGE 11
LOT l5
EVERGREEN STATE BUILDERS
YELM TERRA
15737 1 o 4th AVENUE SOUTHEAST
YELM, WA
J'fp
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<'Z7ijf
CURB
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sTORM LINE
__ ___________-__________1_ -
SEWER LINE I
I
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WATER LINE I I
I I
: 104th AVE. SE :
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CURB
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SIDE~__
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SITE PL~N APPROYAL
A'PPROVEO ^S I'IIE~cNTf.~ 10 REVlSl AND nE~I!I1.Mli' ,-
RE"'Wr~ It( (CUEm),
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NOTE'Sl
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~ SITE PLAN
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@ 200':> CASCADE RE5lDEI'HI A.L DESIGN, II'.IC
...-0
SCALE I' : 30'
THIS ~~AWINr. " ~AsrD o,J ~.,lnIT-PROV'DEP INrORMATION RF.p~ESENT[D TO R' A~CURATE
AND 'ELlA~Lr, ANY DISC'EPMI~I.~, BETWEEN TllIS DRAWI~I(; ANP THE ACTUAL ~ITr, CONDlilOfl5
^~E THF. SOLE R~$rONSI~ILlTY or THr. CLIENT
PlojeoIMdm"i)z/f2.~.de~~ ~#9.d~z.. _.___
5UbdivI5Ion;.y"e ~~j,_l! ((.'!l, Lot fI. 2~,~ lornn9; ~~L!J, ~jt, --1(:t!1i!"'(J
~ew r..onslructlon u Re--Modell Ht)-Hw I Addi!llll'l U Home Occup8tinn SIgn
u Plumbing LI Mechanical l J MrJbllg. t ManUlfnctut'OO Home PlatJemi~nt U Oltls!'
Projeot 0lI8a1pIJ0r;",opeofWoIit<~Ie.J"l!!Ii!:j~_~6."'f_L__
Project Vealue:_ 2/e 75'~_..__~._--,--,-,-_._.._._----~ReGe iv ed
Building Anita (sQ ft) 1~1 Floor~,Z 2"tJ Floot;.a2L (';tlraga .~r OOc.:kg{(fi 2005
BaIiiBment_.___..______. CsrpoI1,__..._,_____'pailo _"___._,
'# Bedl'oorns_!I # BathrOOrn$,_.J Hea!l,.tQ::~~)THER or ELECTRIC (CIrcle One)
Ar'e the(~ ~JnY t~l'lvlj'(mt'l'lerlla/ly sanl!Jitivl!l araalil located on the p.!'m;el'?_______.
compJfited arlvlrunmun\al thfJckli~t must accumpa.ny parmll application
IfYliJll.8
Buii,oiNG" OVI{NE~ i~AME:~~-.:E""---(.~j~~~' ' ti.'~_t{~1iltlt:',\$'J:U1"":=:=-::-----
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~___ Copy of rn"i~jatlon agreSf)"j(lmt with Yl'.llfrt COl1'lrflUl'llty Seh()Qla. ff appHclbJ0
I h"l"Iolb~ \!Qttl1v Itlllt UllllltIO'Jllln1cmlll'ltion illll~\:Imt()R Imil ll'ml UtlJ (;m~lI~r\lll~IUfllm, tllid Ihl! Ul:itlUpill,my .rld (he uue oUha
Ilb()~.. de(luribad ProlHl'111 w!fl bIllrt !l&:\lOrdlllnCfl Wllh tltl'f II/Wll, rullJfllilm.l vWlgllllulJ~n!l a11hl 81l!lle of Wllshlllgllllllmd 1htl
City of Vulm.
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Applicant', Slllnatur'J.,."."'-_.""......,,--",,.,~. OaN
Owner J Controctor(Owner'a Ag!!J!l Contractor'" AYl:'Jnt (Pts8ee tlin:;l' ant:,)
-------.....-.--..
All permits are non.~:r!lmderlble and win 0)1: ph-I It work I1mthor&:r:ed by IUch ".rmll i. not begun
with'n 180 days of it!lllla~tl, or if work illl $u~pended Of abandoned 'Dr' a period of 180 dl1Y1
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P080lt 479 (3fJlJ) <188.-3144 FAX
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