BLD-05-0172
~~
CIi'( Of '(ELM - 8UILDING DEPARTMENT
RESIDENTIAL CERTifiCATE Of OCCUPANC'(
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Building Address
~nS~
~~
~
Plan Number
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owner Name
owner Address
Remar\<.s
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Building permit Number
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Areas Inspected
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special conditions
Qate
Building Q11icia\
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1hiS structure is in compliance with lhe InternalionalHesidential Code (Chapter
51-51 W"C) as adopted bY the washinglon Slale BUIldIng Code CouncIl pursuant
10 Chapters 1921 and 10 92 RCW, eflectIVe July 1 , 2004
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CITY OF YELM INSPECTION LOG
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PROJECT 7;;iJ. 91/
PER.l\11T NUMBER 6 S-r e/7 ~
ADDRESS
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FOOTING
~ 12"'
~16"'
CJ other
1] reqUired \ ents
WALL
CJ 6"'
o 8"
o other
SET BACI\S Date
/1/ O'V F rant
V\ W ;') LP Rear
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Side
FOOTI'\G REB.\R
Date
\\' .\LL REB.\R
D~lte
Cormnen!5
CO\lBI~[D FRA'lEI EXTERIOR SHEAR \\' .\LL I'\SPECTIO"l
Hold downs :J Shear Nading ,. -I-
Frame i W-,'j'4 Gas'Propane ::J ~ /fr3f(J(
Plumbing "] o.l,~ M t--1echamcal '] _
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C Comments
I'\Sl L.\TIO"\
::J Gas
o Foam and Se3.1
~ ElectrIc
:::) \' 3.por barrIer
" Other
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Comments
SHEET ROCKiSHEAR \\' .\LL '\ .\lL
Comments
OTHER
Comments
Fl '" .\ L
I \.-~:s Se\\ er Final
:J :\ddress
Q Electrical
1] InsulatIon
1] eJ\ 11 FInal
o Slte Drainage
CJ Landscape FIn~d
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Comments
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FROM YELM SEWER DEPT
FAX NO. 360-458-8165
Dee 29 2005 03 30PM P1
FAX TRANSMISSION
CITY OF YELM
P.O. BOX 479 - 931 NP ROAD NE
YELM, W A 98597
C' \ 360-458-8411
~- \ t1 D 0 FAX 360-458-8166
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TO: b-RE1(f""v
DA TE; J 1,-.l.f -0 ')
FAX#:
PAGES: J , including this
Cover sheet
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** If you do not receive all copies or any copy IS not legIble, please call (360) 458-&4] ]
as soon as pass] ble
FROM YELM SEWER DEPT
GAK~
TO: I:rI2E
FAX#:
FRX NO 360-458-8166
Dee 29 2005 03 30PM P1
FAX TRANSMISSION
CITY OF YRLM
P.O. BOX 479 - 931 NP ROAD NE
YELM, W A 98597
360-458-8411
FAX 360-458-8166
DATE: 11- ;~..J-o-r
PAGES: J , including this
Cover sheet
From' ~f))JQY
Subject: 1-1 ~ tA)1.< p/ iJAY Iff!. L. 'rr\ 1elttll
COMMENTS: LoT q ~/ I ~-<::jl ~ T'€L", 7Ej(.(ttJ LuA~ '$~lE.
oS-SQ(g6. {)b
"'* If YOll do not receive all copies or any copy IS not legible; please call (360) 458-R411
as soon as possible
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0172-YL
Issue Date. 06/28/2005
(Work must be started within 180 days)
Receipt No
37126
Applicant:
Name: Evergreen State Builders
Phone:
253.475.6622
Address. 3815100th St. SW, Ste 2A
City' Lakewood
State. WA Zip 98499
Property Information:
Site Address. 15816 Yelm Terra Way SE
Assessor Parcel No. 85840009600
Subdivision. Yelm Terra
Lot: 96
Contractor Information:
Name: Evergreen State Builders
Contact: McCullem, Tom
Phone: 253-475-6622
Address. POBox 197
City' Lakewood
State: WA Zip: 98499
Contractor License No: EVERGSB980PB
Expires. 10/02/06275
Business License.
Project Information:
Project: Yelm Terra
Description of Work: Plan 1740B/2 Lot 96
Sq. Ft. per floor (1 st) 854
(2nd) 952
(3rd) 418
Garage 0
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 1 149 15 993.75 155.40 5 6000 277500 $1,000
Building Plan Review 485.51 000 0.00 0.0000 o 0000
Mechanical Permit 78.75 000 0.00 0.0000 o 0000
Plumbing Permit 111 00 2000 9100 7 0000 13.0000 Fixture
Sewer Inspection 14500 000 145.00 145 0000 1 0000 ERU
Water ERU 1 500 00 0.00 1,50000 1,500 0000 1 0000 ERU
Water Meter (SFD) 300 00 300 00 000 0.0000 o 0000
Water Deposit 4000 4000 000 o 0000 0.0000
Traffic Facilities Charge 757 50 000 757.50 750 0000 1 0100 Peak PM Trip
Sewer Deposit 5000 5000 000 o 0000 o 0000
State Building Fee 450 4.50 000 o 0000 o 0000
Sewer ERU 5,41700 000 5,41700 5,4170000 1 0000 ERU
TOTAL FEES. $10,038.41
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 / ~ -
~S4
# Sets of Prints.
Final Inspection:
Date
~~.r
Date:
/2.-)0 ~ct'5~
Jrj(
Firm
By'
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Permit Fees Schedule
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name. Evergreen State Builders
Address. 3815100th St. SW, Ste 2A
Project Information:
Project: Yelm Terra
Description of Work: Plan 1740B/2 Lot 96
Site Address. 15816 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 032001-322-10-00
Sewer Inspection 805 412-343-80-00
Water ERU 712401-343-80-01
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 802412-343-50-01
TOTAL FEES.
Permit No BLD-05-0172-YL
311 ~(,.,
Phone'
253.475.6622
City' Lakewood
State. WA Zip 98499
Assessor Parcel No. 85840009600
Item Fee Base Amt Unit Fee Unit Rate No Units Unit Desc
-------------
1,14915 993 75 155.40 5 6000 27 7500 $1,000
485 51 000 000 0.0000 o 0000
78.75 0.00 000 o 0000 0.0000
111 00 2000 9100 7 0000 13.0000 Fixture
145.00 0.00 145.00 145.0000 1 0000 ERU
1,500.00 000 1,500.00 1,500 0000 1 0000 ERU
300 00 300 00 000 o 0000 o 0000
40.00 40.00 0.00 o 0000 o 0000
757 50 000 757.50 750 0000 1 0100 Peak PM Trip
5000 5000 000 o 0000 0.0000
4.50 4.50 0.00 o 0000 o 0000
5,41700 000 5,41700 5,417 0000 1 0000 ERU
$10,038.41
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I 'f~~~ YELM I
I ~~ PO Box 479 3""'125
! ~ 'relm. WI, 9<J597 RECEIPT No (
. .Y'Eb!.1".. 060-455-5403
FEC~!VEn
-~*-rEN THOUSAND FORTY rIVE DOLLARS & 06 CENTS
RECEIVED FROM
DATE
REC NO
AMOUNT
P,EF 1\10
EVERGREEN STATE BUILDEPS
P 0 BC)X 39753
,j6/::'::"~)') 371~5
1(3. Cl4 5 06 CHEn:
FENDING
LAKEWOOD WA 98499
BLD-05-0171-YL
2 ITE 152::::: = YELl! TERRA viAY 5E
BUDGETARY
q <6gLl
JiICHELLE
BLD FEP!l 114~; 1", BLD PL HEV 4Sc. 66 HECHFllT7:: ':::, FLU!! HIT 11:
WFTERU1500 ,WTHET3CO 0 WTDEP40 ,TFFCHG7~7 50,3EWDEP50 ,~TBL[rEE4
::1 VII N 3 F 1 :J :: ,
50,SEERU5417
. .
. I
. ." B:'
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. .
RECEIPT No 37126
RECEIVED_ __.
.w*'~~N THOuSAND THIRTY EIGHT DOLLARS & 41 CENTS
RECEIVED FROM
EVERGREEN STATE BUILDERS
:215 100TH 3T SW STE 2A
LAKEWOOD WA 98499
ELD-Q)~-017::::-YL
15816 YELM TEPRA WAY S~
DATE
----.....
06/28/05 ::'7L::i.J
/
I ".
'"
BUDGET1"FY,
AMOUNT ',\ REF NO
10,028 41 ~1~~; ) fENDING
--" //
~_.,--.-.__..,_...__._-~---_..........
HTCHELLE
BLDE'11T 114'? i5 FL F:Ev'4ES 51,IlECHFHT78 7:>,PLUlIPllTl11 ::,EiHN:::P145,viHTEPU150C;
WTMET~00 ,WT[EP40. TRAP757 50,SEWDEP~0 ,ETBLDFEE4 ~0,SEW ERU 5417 00
- -- -.-.- - --- - -.-.-.-.- - -.. -.---1
RECEIPT No 37127
FlE(;FIVEn
.~*YTEN THOUSAND TWO HUNDPED FIFTY rIVE DOLLARS & 42 CENTS
RECEIVED FROM
EVERGREEN STATE BUILDER~
DATE REC. NO
AMOUNT
REF NO
06/::8/05 37127
10,255 4& CHECY
q ~?Cl
PENDING
p n BCX 39753
LAfEWOOD WA 98499
BLD-05-u185-YL
SITE 15776 YELH TERFA WAY SE
BUDGETP.P 0[
IHCHELLE
B L D P E F 1 ::: 2::: 7 1 , B L D P L FE; V 5 4.c O:2,]j E C H P l! T ,j <1 7::, FLU IE F-.'I' 1 3:2 ,.3 E h' IlLS P 1 4 5 ,\ m T E R U 1 :: (J ')
vIPTl1ET=')0 ,l'IRTDEP4C1 ,TF:l',F'CHG757 5(i SEi'WEPS(1 ,STBLDFEE4 5C1.SE\'IERU5417 00
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Yelm School District
ATTN SUSAN CROY
PO BOX 476
YElM, vJA 98597
360-458-1900
Sold to. 16755
EVERGREEN STATE BUILDERS LLC
56622
BUILDERS LLC EVERGREEN STATE
5516 75TH 8T W ~1
LAKEWOOD, WA 98499
# 6164 10 06/28/05
Reg #1 SalesPerson SUSAN
Item ~ 2900/MITIGATION
MITIGATION/CAPITAL PROJECTS
1 @ 8,555.00 8,~ 00
CK #09891 FOR lOTS 76,86,91 9 ,97/YELM T
ERRA
SubTotal
8,555 00
Total Due
Check
8,555 00
8,555 00
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----------
Thank you
PLEASE KEEP THIS RECEIPTI I I
projeC'Addrass:~Q_yp~ 7ii'ft'LA ~J'~ ~~#'_~2f/~4' _.___
SUbdiVi$ion;~/wt 1~e((tf[ lol#'~~ l()n,n9;J~~~:e -f{f!!:t!.L!j
'~ew Construction u Re-Modell Re-.Roof I Addition u Home Occupation Sign
u Plumbing u Mechanical U Mobile I Manumctured Home Placement U Other
Project Description/Scope of Work:~{e -FuJWL!~_-.f!e 6/ dMl, cl-t
Project Value" ~ 3 ~ 7',s(J ___~.~_
Building Area (sQ ft) 181 Floor .f1...s:.Y tltl Floor..f'$' ~ Garage $/..!I Deck
Basement Carport___Patio~~/h ~
# Bedrooms-I.. # BathroornsZ!,s- Hea!jng~OTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas 10catad on the p.arce/'? ___
completed environmental checklist must accompany permIt application
If yes, a
BUILDING OWNER NAME::::::EJ-- t-'-; , '1~e.. &:it !~~ (! _ -
ADDRESS-31iL:s:. - -~: /00 ~{\ -. I ',~' _EMAll..c;- S' I~ -c!Cbtuci:il:'M~
CITY ~l. STAlE _ lIP~~:.t. . ~TElEPHONE " S-- --..- '_.
"ARCHITECT~NGJN~ERdW~~Fa?t},F~~~ICENSE#~~ .. ~,- ,
ADDRESS~. ~ 2~f~Pk:;;t _EMAll&~~~ i'E ~ . :~-
CIlV-.J2(/)J[{]fl : _~ STATE~z;r-~~Z . TELEPHONE. - ~ 'l_~(1/16
GENERAL CONTRACTOR. '..92/11lfJ.tl.c.?,S (JJWLU:""" TELEPHONE.__ . --.
ADDRESS..______. ~__~EMAll ..
CITY STA 1E zap FAX
CONTRACTORS Ll~SE # (F~iI. ~E:l<.P D.A ~riY .LICENSE # ~
PLUMBING CpNTRl\\ilOR ,a~~~TELEPHONE~53. 7. -if. 9J (.)
Ar)[)RESSjl?/[? ~o//ft -w-7 ~ EMAil
CITY /2l(lj~-' STATE - zW"'8W?-'-FAX25'",3' ",5."'~9?~~ __
CONTRACTOR'S lIC~~~~.~':::;.=____~__.,::. EX? DATE_CITY ,LICENSE #
::J
--.--......
MECHANICAl CONTRACTOR~..___
ADDRESS____
CITY.____.,_STATE
CONTRACTOR'S LICENSE #
o
JF..LEPHON~
___~__EMAll __._____
ZIP _____yAX.___
EXP DA TE.....__..crrv L1C~NSE-# __
Copy of mitioation agreemt:mt with Yelrn Community Schools, if applicable
I hlll1Jby certify thlll the ..110\:111 InfonYlaUoullll l,':orrooS "lid that tho clmstrucilun e/fl, and thl! occupancy and !hit use of the
IIho'l/'" d&lIcrfbed property will ~ In 8CCordilll'lCll with the IIIWS, rulBIl and ntgl.dutlolls of the Stole of WI1f1hlnglon snd the
Cttyof Yslm.
/~_~,~ -, ___. .6-/0-//<5-
AppJlcant's SlgnaturJ.._,,----- Date
Owner J Contractor(~~ Contractor's Agent (Please circle one,)
All permits are non~tranlSferable and will expire it work authm'i:ted by such permit is not begun
within 180 days of Issuance, or If work is suspended or abandoned for a period of 180 daY1l
10,6 Yl!lm Avenue WI!8t-----------"---.----"---"-~a60J 411a:3S.'J6 ----
PO Bo~ 479 (360) -I1J/l...3144 FAX
Ylllrn., WA 98597 www.IJi.,."lm.wtJ.Wl
05/09/2005 15 05
2532843183
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EVERGREEN STATE BUILDERS
YELM TERRA
YELM, WA
~ITE PLAN APPROVAL
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PAGE 04/05
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NORT~
SCALE I" = 30'
T~I:; PRAWING I. aA.m ON CU[NT-PROVIOEO INfORMATION REPRf,Sf;NTf;D TD Be ACCURATE
ANO RWABLE. ANY DISCREPANCIES AETWeF.N TI1IS DRAWING AND TH~ ACTUAL SITE CONDITIONS
ARE YHE ~OI.E R[~rONS'OILlTY OF THE WENT