BLD-05-0175
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CITY OF YELM _ BUILDING DEP A.RTMENT
RESIDENTIA.L CERTIFICA. TE OF OCcUP A.NCY
owner Name
owner Address
~enS~
~
~
Building Address
~
Plan Number
~
RemarKs
~
Building permit Number
special conditions
~
~
Areas Inspected
Date
Building OHicial
~
ThiS st,ucMe is in compliance with the International Residential Code (Chapte!
51.51 WI'C) as adopted bY the washington state Buitding Code councIl pUfSuant
to Chapte!S 19.27 and 70 92 RCW, effectNe July 1, 2004
~r;:--'1r~\@i\\i@Jt@S@j@~iJffiIDS@l\@~@1j@\wj@l)r
FROM YELl1 SEWEP DEPT
FAX NO 350-458-8155
Mar 17 2005 04 43PM Pi
FAX TRANSMISSION
YELM '\ CITY OF YELM
W_~'''OT''", \ P.O. BOX 479 - 931 NP ROAD NE
~ \i '\j, YELM, W A 98597
[-,~~ \. 360-458-8411
, (' FAX 360.458.8166
TO: c"g*AJ DATE: '3>- 17-DCo
FAX#:
PAGES: /, including this
Cover sheet
From' R.A.uD~
Subject: Ho uSE" F,-~AL5
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** 1 f you do not receive all copIes or any copy l~ not legible, please call (360) 458-8411
as soon us possible
CITY OF YELM INSPECTION LOG
~
~
PROJECT
PltV'YL d d~qo/ /J
PERMIT NU!\1BER 0 S- - 0 /7 S-
ADDRESS I '5"7:2 ~ '!--P) M !e-rflC/
Lo+ '3 S
uluy 5E-
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SET BAChS Date
Front
Rear
Side FlarU.lng
Side
FOOTING
~ 12"'
~.,
CJ other
'3 0 requITed \ ents
../' Date ~\\' \LL REB.\R ~ 11/1}/
WALL
CJ 6"
)6' 8"
o other
FOOTI'G REB.\R
Comments
CO\lBI;\[D FRN\lE/ E\. TERIOR SHEAR WALL I'\SPECTIO'\
/.. Hold downs ::J Shear Nadln~ CJ
v\ IVq IJO Frame i. (~ldJU Gas 'Propane- \ i.' JII--- [tJb1
Plumbing :J ()I......JiJ}1j Mechanical /'<g /
OJ
C Comments pJe/llllL... 1~/J4 .5~
"
I'\SlLATIO"l "'3 Gas IJElectnc" Other
"'''8 Foam and Seal :::! Vapor barner ~ P\'-\
Comments
SHEET ROCK/SHEAR \V .\LL '" .\IL
Comments
OTHER
Comments
Fl~ ,\L
'--0 Se\\ er Final
':J l~ddress
Q Electrical
o 1nsulatIOn
o C1\ 11 FInal
o SIte DraInage
:J Landsc~re Fln31~ C (If 0
'I Slde\\31k,
Comments
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0175-YL
Issue Date 08/10/2005
(Work must be started within 180 days)
Receipt No
37957
Appli~al}t:
Name. Evergreen State Builders
Phone.
253-475-6622
Address. P.O Box 39753
City' Lakewood
State. WA Zip 98499
Property Information:
Site Address. 15728 Yelm Terra Way SE
Assessor Parcel No. 85840008500
Subdivision: Yelm Terra
Lot: 85
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. 10/02106275
Business License: 1042.0
Proj~c:t Information:
Project: Yelm Terra
Description of Work: Plan 21505/2, Lot 85
Sq. Ft. per floor' (1st) 888 (2nd) 1262 (3rd) 0 Garage 432 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 1,276.77 993 75 283.02 5.6000 50.5400 $1,000
Building Plan Review 539.44 000 0.00 0.0000 o 0000
Mechanical Permit 78.75 000 000 o 0000 o 0000
Plumbing Permit 132.00 20.00 112.00 7 0000 16.0000 Fixture
Sewer Inspection 14500 0.00 145 00 145.0000 1 0000 ERU
Water ERU 1,50000 0.00 1,500.00 1,500 0000 1 0000 ERU
Water Meter (SFD) 300.00 300 00 0.00 0.0000 o 0000
Water Deposit 40.00 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 0.00 o 0000 o 0000
Sewer ERU 5,417 00 0.00 5 417 00 5,417 0000 1 0000 ERU
TOTAL FEES. $10,240.96
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 1--/e:!J-l!IIt.S-
Firm ~ S4
# Sets of Prints:
Final Inspection:
~- "2' cr 0 "-
Date: .i1 p
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By'
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PO Box 479
Yplrn WA 98597
360-458-8403
RECEiPT No 37 955
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RECEiPT No 37956
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PAID
Permit Fees Schedule
City of Yelm
co~~uni~ ~~velopment DepartmenAUG 1 0 2005
BUlldmg DIvIsion
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name. Evergreen State Builders
Address. P O. Box 39753
project Information:
Project: Yelm Terra
Description of Work: Plan 2150S/2, Lot 85
Site Address. 15728 Yelm Terra Way SE
Fees.
Item
Acct Code
Building Permit 100-500k 032001-322-10-00
Building Plan Review 100001-345-83-00
Mechanical Permit 032001-322-10-00
Plumbing Permit 032 001-322-10-00
Sewer Inspection 805 412-343-80-00
Water ERU 715401-343-80-02
Water Meter (SFD) 712401-343-80-01
Water Deposit 740402-389-00-00
Traffic Facilities Charge 420 120-345-85-00
Sewer Deposit 742402-389-01-00
State Building Fee 160 001-386-00-00
Sewer ERU 802 412-343-50-01
TOTAL FEES
Permit No. BLD-05-0175-YL
CITY OF YELM
f2) 71'S 7
City' Lakewood
Phone.
State: WA Zip 98499
253-475-6622
Assessor Parcel No. 85840008500
Item Fee Base Amt
1,276.77 993.75
539 44 0.00
78.75 000
132.00 2000
14500 000
1,500 00 0.00
300 00 300 00
4000 4000
757 50 000
5000 5000
450 4.50
5,41700 000
$10,240.96
283.02
Unit Rate No. Units Unit Desc
Unit Fee
000
o 0000
5.6000 505400 $1,000
o 0000
0.00
0.0000
0.0000
16.0000 Fixture
1 0000 ERU
1 0000 ERU
o 0000
o 0000
1 0100 Peak PM Trip
o 0000
0.0000
1 0000 ERU
112.00
7 0000
14500
145.0000
1,50000 1,500.0000
000 o 0000
0.00 0.0000
757 50 750 0000
000 o 0000
000 o 0000
5,41700 5,4170000
() LOT B:, 0
EVERGREEN STATE BUILDERS
YELM TERRA
15728 YELM TERRA WAY SOUTHEAST
YELM, WA
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YELM TERRA WAY
_______________L_________
STORM LINE
G~ SITE PLAN
.
@ 2005 CASCADE RESIDENTIAL DESIGN, INC
@
NORT~
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
.. ~ ~
Project Addra6sCU~y~ ~~ ~ ~I0~/S-O ~L~...~__
SlJbdjVlslon;_Ve{;vJ.._I~(L1-" l.o!#~. ~,.".~.. ~Ula'l /' /
_l~_.~_,,_ ~';....__._ l..onir\9; ~Jji.:-....,t t:f!:11J...! j
'~ew t'..onstrut1iun . U Re-Modall Reo-Hoof I AdditioN u HOMe Occupetitl" Sign
u Plumbing lJ MsvhSl1lcol t J Mobile f MamJlfuctul'oo HOMe Placement u Olhttf
Project Da9crjptior1J~;oope of Work: .~ii:ldl4J...le. .f;.Ik!L I (fj_ e~~ 6..( dlt!J:-l (~__
Project Value: ~ 3 75 ,,~o _._______ _.._
Building Area (sll 11) 1S! Floorg~ tIll Floor~ ~? GI:ltelg9 J:L3:- OeckL-P"O
a~fijBmflnt__.____ Carport___._._Patjo__
# Bedl'oom~ # Bathrool'YlsJ He811f1g@JbTHER or ELECTRIC (Circle One)
AI'6 theru any (lmvlrt:mmat1tal/y S611t'lit/V19 ar9f.!1Ji located on the pureel? If YIiJIi, a
compJ~ted 0nvlrOhnlUn'al checklist must accotnpany permit apphcution.----
-Bu~LDII\lG O~Ef~~AME:=-li:~--t--/; -:;. I , 7ii~-l?Z;;i1/jL,.?:-// ~
ADDRESS _'::.;..1fiL.;.L:::.LQ{2......~1 ' . .' (.h~{{ii;i EMAll ...c;,.~
erN ~~~=-~T A n(Jj'L_lIP~~~-.: 11~LtPHONELlS"~~, ,.
[ARCHrrECl'JEN.GIl~iER"7W~~Z&I&-I~~KI~~ICE.NSE # =~- . ~ ]
ADORESS_':.0_~'?l!.~~ . _EMAlt~_
crry~g:(~~~STAjE~I!~ZiP3C~~~~~EPHoi'iE~2E31 2r-:li~ ..
GENERAl. CONTRACTOR. ~WIlll(ti4--:S7fi(jttk~._ n~'LEPH()NE"__=--'_.~-"=:"'~-J
ADDRESS..__._,.,..______ __~___EMA'l __.. ~ '
CITY. STAte liP FJlJC
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[PlllI.I3ING C9Il.T~OR~~W~'ELEPHONE~~7~J
~~~~~~~~~-- ~~flZfT=l'P !l8~Ift?'~~~~:~is:~,,5:~::9~==
CONTRACT()R'$I~ICr:NSE #. .~_..~.~ "... FJCP OATE_~CITY LICENSE #____
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MEC. HA. NICAL co"n.RACTOR~d~. ~.'~ jliE.:PHONEMi w.L?~W...J'.j((Q -J
ADDRESS~~~~~______.~__.[MAIl. ._._.__,-_._.~___
CITYg~4_.___STATE.~4 _._lIP ~LZC _FAX____.__________
CON~~1:!lg~~ #~::,,"'iI tC~. _ EXP OA TE."'._...C~~~~IC~~~fL~ -~ . _...' ",.,,_
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Copy of I'Ylitl~latJon agr$Smf!lflt wiih Velm Cot"!'trrlurlity Sel'!ooli, if Illpplieabl"
, htlN'lby ;::ertlfy Ihtll !lIl1 ubovtl blhmlll'itlofll!S l~ldl'rtlti t.lmJ thut illt! \llmll'irI.l'~UUl1 011, "lid Ihe Ol:llll.lpil'my end jtlt! use or 1ha
ubU'l/fl de&tlrfbed pro!Hl.111 will be hllllmordlllrlC6 with the lilWll, nllolllo1nd ~~glU'IlU~n8 of 1he litulu of Wl'lshlnll1on snd 'he
CHy tlf Vulrn.
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AppllcQrdlS SiSlnatlJr,..".~.,,--...._.~.-.... Date
Owner' / Contrsctor(Qwner'lI AQ!!J1J Contractor's AQlmt (Pie.... Girel. unc.)
-~...............
AU permit. are l'1on-iransfell'obie *nd win oxp'rtt if wUrk l!I~dhor~lf)d by such permIt il not begun
within 180 days of ilw9UIU'le8, ot' if wt)rk II $ulllpendilld at ab~nd(Jn.d feu' a period of 180 dlJys
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PO 80. 4'19 0180) ~tJs....ai44 FAX
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