BLD-05-0171
iWJ~
crN OF '(ELNI _ BUILDING DEP AR1N1ENl
RESIDEN11AL CER11FICA1E OF OCCUP ANC'(
Building A.ddress
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owner Name
owner A.ddress
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Plan Number
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RemarKs
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Building permit Number
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A.reas Inspected
oate.
special conditions
Building Official
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This structure is in complianCe wtth the International Residential Code (Chapter
5j-5j W/>.C) as adopted bY the washington Slate Building Code councli pursuant
to Chapters j9 27 and 70 92 RCW, efleelive JUlY j, 200A
l'~~,'l SEWER DEPT
FRX NO 350-458-H155
Dee 15 2005 03 28PM Pi
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CITY OF YELM
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YELrvl, WA 9~59J
360-458-8411
FAX 360-458-8166
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COMMENTS: L.oT 0,'-1 I ~~ 6l{ lE:uY\ ~R-t'j) wAl( ~,E
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h If you do not receIve all copIes or any copy IS not legible, please call (360) 458-8411
a~ soon as pos:;ible.
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CITY OF YELM INSPECTION LOG
PROJECT
U f7 "IT
PER.~llT NUMBER
lj8~ :;A
/~~~ 0~~
~" SE
,
o\DDRESS
&S'""... 0/7/
\\' ALL
CJ 6"
YS"
. 0 other
D:lte
Co!"!:mer:ts
CO\lBli'ED FRA;\l:: L\. TERIOR SHEAR W .\LL I\SrE~TIO~ t;.:(lf) A- ~ff.
Hold downs ..J . Shear NaIlmg CJ ~ ;J':j . ,
Frame A~ if jAI17 GasPropane J{ .~ i ':57iK
Plumbing . JJ. . "/iJ"' Mechanical /; I
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~ Other
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OTHER
Comments
FI"'IAL
[] Se\\ er Fimd
:J l-\ddress
[] C1\ 11 Final
o SIte DraIn3.ge
CJ Landscare Final
'I Slde\\ all
n C[lfO
Comments
SET BAChS Date
~ / Front -ztJ
.\Air &"/'W Rear .::3te
&~ tj) SldeFl3.rU.Ing ?
Side /;)-.,
FOOTrNG
~ 12"
t11l6
CJ other
o required \ ents
FOOTI'\G REB.\.R
D3.te
W .\.LL REBAR
Comments ~~5
I'\Sl LATIO"'l j Gas
j F O3.m and Seal
CommentsJ/ /017/,,(
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SHEET ROCK/SHEAR ,\' .\.LL '\ .\.IL
~ ElectriC
Vror b3.ITIer
Comments
Q Electncal
[] InsulatIon
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0171-YL
Issue Date. 06/28/2005
(Work must be started within 180 days)
Receipt No
37125
Applicant:
Name. Evergreen State Builders
Phone:
253-475-6622
Address. POBox 39753
City' Lakewood
State: WA Zip 98499
Property Information:
Site Address. 15822 Yelm Terra Way SE
Assessor Parcel No 85840009700
Subdivision: Yelm Terra
Lot: 97
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: 1675/3 Lot 97
Sq. Ft. per floor (1 st) 908
(2nd) 767
(3rd) 0
Garage 413
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 1,14915 99375 155 40 5.6000 27 7500 $1,000
Building Plan Review 485.66 000 0.00 o 0000 0.0000
Mechanical Permit 78.25 000 000 o 0000 o 0000
Plumbing Permit 118.00 2000 98.00 7 0000 140000 Fixture
Sewer Inspection 145.00 000 145.00 145 0000 1 0000 ERU
Water ERU 1,500 00 000 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 0.0000 o 0000
Traffic Facilities Charge 757.50 000 757.50 7500000 1 0100 Peak PM Trip
Sewer Deposit 5000 50.00 000 o 0000 o 0000
State Building Fee 4.50 450 000 0.0000 o 0000
Sewer ERU 5,41700 000 5,417 00 5,4170000 1 0000 ERU
TOTAL FEES $10,045.06
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 / ~ e'"
Firm #S-<:J
Date
~-ZJ'-6~
Date:
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. P.O. Box 39753
Project Information:
Project: Yelm Terra
Description of Work: 1675/3 Lot 97
Site Address. 15822 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 805412-343-80-00
Water ERU 712401-343-80-01
Water Meter (SFD) 712401-343-80-01
Water Deposit 740402-389-00-00
Traffic Facilities Charge 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
Permit No BLD-05-0171-YL
3 1 \ d-)
Phone:
253-475-6622
City' Lakewood
State. WA Zip 98499
Assessor Parcel No 85840009700
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 66 000 000 0.0000 o 0000
78.25 0.00 000 0.0000 o 0000
118.00 20.00 98.00 7.0000 14 0000 Fixture
14500 000 14500 1450000 1 0000 ERU
1,500.00 0.00 1 500.00 1,5000000 1 0000 ERU
300 00 300 00 000 o 0000 0.0000
40.00 40.00 0.00 0.0000 o 0000
757 50 000 757.50 750.0000 1 0100 Peak PM Trip
5000 5000 000 o 0000 0.0000
450 4.50 0.00 o 0000 o 0000
5,417 00 000 5,41700 5,417 0000 1 0000 ERU
$10,045.06
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I ~~:~ CITY OF I
'I fL-~ YELM '
~'~/r~ -,1"7 I
i k~ yi~~_~r~~!57 RECEIPT No 37125 I
II F't:g~I)I!=P.';;,N "'. I
.~ THOUSAND FORTY rIVE DOLLARS & 06 LENTS /-
I /" 1
I RECEiVED FROM DATE REG NO /. AMour~T \, REF NO I
EVEPG~EEN STATE BUILDERS 06/,5/05 =71~5 10,045 06 CHECh .ENDINGI
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POBOX 3:37 53 o~gCl) 1111;
LAKEWOOD ~A 9~499 EUDGETARY -I ,
BLD-()5-0171-YL
SITE 1~32= YELM TERRA WAY SE
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ELD PEP1! I14~1 It:;!l BLf: PL HEI! 455 6G} 1','iECHFl.1T '7~ 2:, PbJlLLF1IT~1..~::--
WPTERU1500 ,WTMET300 0 WTDEP4), ,TPrCHG757 ~C,SEWDEP5n STBLrfEE4
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50,SEERU5417
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RECEIPT No 37126
RECl=IVi=D
~ ~-.. "TEN THOUSAND THIRTY EIGHT DOLLARS [( 41 CENTS
BUDGB'I'AEY
AMOUNT
10,033 41 I..HEeF
DI ~ gel
REF NO
RECEIVED FROM
EVERGREEN STATE BUILDERS
:215 l00TH ST SW STE 2A
LAKE WOOD WA 98499
DATE REG. NO
06/2,3/(:'5 371.::.6
FI'NDING
B IJ D - 0 5 - 01 7.2 - r-L
15816 YELl! TEPLu. \lJ~,'{ SE
HICHELLE
ELDfll'T 114'315 FL EEv4Ec 51,liECHPIIT78 75 FLUlJPIIT111 ,bEI'iIN:'::Pi-15 ,viRTERU15()C:
WTMETJ00 WTDEP40 TRAF757 50,SEWDEF50 ,2TBLDFEE4 ~0,3EW ERU 5417 00
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~.":(\~:~! CITY OF
I~Y ~I YE.LM
~ ,;
~.. ...... Ye~~0%x:Z;97 RECEIPT No 37127
~ 260-453-8403
RECl=I\!~D
-~* 'TEN THOUSAND TWO HUNDPED FIFTY rIVE DOLLARS & 4E rENTS
RECEIVED FROM
EVEFGREEN ~TATE BUIIDER~
DATE REG NO
0G/:28/05 37127
AMOUNT
10,255 4E, CHEe?
q ~ rCl
REF NO
PENDING
f'tl BeX 39753
LAYEWOOD NA 98499
BLD - (15 _1,]1 b 5 - YL
SITE 15776 YELH TE?~A WAY SE
BUDGETP.E"{
l!ICHELLE
B L n P E f! 1. =- 8 =: 7 1 , E: L D P L B B V :; 4 ,C (5::', II E C H F ii T ;:; ,~ 7 =, , E L U IE P T L. 2 , ,: E vII 11.:::; P 1 4~' . 1J R T E R U 1 ~,cf\
I'm TilE T :: 0 el . vi R T D E P 4 (;) . T F l; F C H G 7 5 7 S () S LVI DE pr:o . S T B L D r E E 4 5 (1 S E Vi Ii R U 5 4 1 7 00
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Yelm School District
ATTN SUSA~ CROY
PO BOX 476
YELM, WA 98597
360-458-1900
So 1 d to: 16755
EVERGREEN STATE BUILDERS LLC
56622
BUILDERS LLC EVERGREEN STATE
5516 75TH ST W #1
LAKEWOOD, WA 98499
# 6164 10 06/28/05
Reg #1 SalesPerson SUSAN
Item # 2800/MITIGATION
MITIGATION/CAPITAL PROJECTS ~
1 @ 8 , 555 . 00 8 ,555 . '
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
----------
----------
Thank you.
PLEASE KEEP THIS RECEIPT'"
05/09/2005 15 05
253(j3183
CAS RES NWAFr-1DM
U
LOT '3l
EVERGREEN STATE BUILDERS
YELM TERRA
15822 YELM TERRA WAY SOUTHEAST
YELM, W A
SITE PLAN APPROVAL
Arr"C~[\ ~~ p~~.l;~~m R['ll'[ ~S-n['"WBlollr
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: YELM TERRA
WAITRLiNr-r==~
_____1______ ____________
SEWER LINE
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ST. ISE
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-=~# -..-
. SITE PLAN
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{) 2004 CASCADE Rt.SIDEI\jTIAI_ DESIGf\1 II\IC
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SCALE \' ~ 301
THIS DflAWiNG is eASED ON CI,Ir,Nt-PROVIOF.a INFORMATION REPRESENTED TO BE ACCURATE
AND RELIABLE, ANY DISCREPANCI~' 8nWE!;N THIS DRAWINC AND THE ACTUAL SITE CONOITIONS
ARF. THE SOLE ReSPONSIBILITY OF THE CLIENT
PAGE 05/05
@
NORT~
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Project Address:/S-g...7:;' vd -r.?e;: ~7C #'--1:- 6/.5/';<
. , /
Subdivision: Yt?/hIl l:e(('~- LolN' ,~7 , Zoning; ~9j{ ---f{1I!1ltjj
-~ew Construction U Re-Modell Re--Roof I Addition U Home Occupation Sign
u Plumbing U Mechanical LJ Mobile I Manufactured Home Placement U Olher
Project Description/Scope of Worle \~ f) If!. faA111 0 f!e ~I dM/'llZ_1
Project Value: $'r1d~ 76D _
Building Area (sq ft) 181 Floor ~?Jg 2tlO Floor.Z67 Garage ~/3 Deck
Basement Carport Patio Z/ b
# Bedrooms.l..-. # 8athroorn~~ Heatjt1~THER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application
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GENERAl CONTRACTOR \W/?llff,~ a.s CfJ-t/Il-4r _TELEPHONE
ADORESS_ EMAIL
CITY STATE FAX
CONTRACTOR'S LICENSE # ev ExP OAT' ~ CITY LICENSE #
TELEPHONE ~,.
EMAll
~ ,'(..".- FAX_23;.~ $~ - q?-<<7
F.J<P DATE_CITY LICENSE #
PLUMBING CPNTRACJ:OR,.J
ADDREsSj~/g ~~
errv 72l{[jYf1rft STATE
CONTRACTOR'S LJCENS~ ~____
MECHANICAL CONTRACTOR___
ADDRESS
CITY, 5T ATE ZIP
CONTRACTOR'S LICENSE fI.
.,
TELEPHONE
[MAIL
YAX
EXP DA TE.....___CITY LICENSE #
Copy of mitigation agreement with Yelrn Community Schools, if applicable
I hereby certHy Ihal the aboye Information ill c:orred and that the construction on, illlld the oecuPilIhCY and the USCI of the
above descrfbed property will bIlln accordance with the laws, mlulI and I1tgulatlons of the Stete of Wsshlngton and the
City of Yelm.
/ ~~~ ~'_' 6 -;/J-~.s--
Appncant's Signatu~-:-:~--=:-:----.:-r Date
Owner I Contractor~ Contractor's Agent (Please circle one.)
All permits are non~tranlSferable and will expire If work authorb:ed by such permit Is not begun
within 180 days of Issuance, or If work is suspended or abandoned for a period of 180 days
105 Ye/m Avenue West
POBox 479
Yelm. WA 88597
(360) <J1SlJ..8835
(360) 458-3144 FAX
www.ci.}1cdm.wa.WI