BLD-05-0165
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CI'T'f Of 'fEL\III- BUILOING OEPARi\lllENi
RESIOENilAL CERilflCA iE Of OCCUP ANC'f
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Plan Number
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Building Address
RemarKS
owner Name
owner Address
Building permit Number
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s{)ecial conditions
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Areas InS{)ected
oate
Building Ofticia\
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Tnis structure is in comptiance witn t\1e tnternationat. Residential Code \ Cnapter t
5j.5j Wr-C) as adopted b~ tM wasnington state BUltdln9 Code Co unCI pursuan
to cnapters j 9.27 and 70 92 RCW, eflectNe Jul~ j , 2004
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CITY OF YELM INSPECTION LOG
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ADDRESS / S' <gO Lf
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ye JWl It! r"~ ! 0 f 94
h~ 7) -05- -Q/65-- Vi-
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PROJECT
PERMIT NUMBER
FOOTING WALL
CJ 12" CJ 6"
o 16" 0 8"
o other 0 other
o reqUired, ents >'
/ Date 1.)1<1)'"' WALL REBAR ~e /../::>J
/
SET BACkS Date
Front
;:...) Rear
J: SldeFlank.mg
\.\~~ '11\,1
~ V"'\ Slde
FOOTIl\;G REBAR
C0!!:mer:ts
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C01\lBI!\ED fR.\~lEI E\.. TERIOR SHEAR \\' .\LL I\SPECTIO~
Hold downs ~ Shear NailIng 0 "
Frame liOJ.A/ul7/ll;I" Gas 'Propane J~JV7 ;tI4ft\"'/
PlumbIng J. i~'l " ~, MechanIcal ::J
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Comments
I\SlL\T10~
:21 Gas
/ (
1 Foam and Seal
CJ ElectrIC
:J Vapor barner
f,.lu"yVI
Comments /)
/ ~Y'.':. J c;;);.\.-
SHEET ROCK/SHEAR \\' \LL :\AI L
Comments
OTHER
Comments
FI"lAL
o Sewer Final
o Address
[J ElectrIcal
o InsulatIOn
o C1\ 11 FInal
o Site DraInage
~ Landscape FInal
:::J Slde\\alk.
o C of 0
Comments
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Dee 15 2005 03 28PM Pi
YELM SEWER DEPT
FRX NO. 360-458-U166
FAX TRA.NSrvlISSIOJ\J
bt1R~
CITY OF YELM
P.O. BOX 479.- 931 NP ROAD 1'JE
YELM, W A 98597
360-458~8411
FAX 360-458-8166
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FAX#:
PAGES: I , rncluding this
Cover sheet
From: \2".AOoY
Subject: H · u:'> l.'O F I;'; 1\ L I 'h LTfl ~ A
05 -59L(6 . DD
COMMENTS: L-.oT q L/ I 'J-.:g 6l( 1E:.LYrI TtRiA w A ~ "'0. E..
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4< >\< If you do not receive all copIeS of any copy 1S not legible, please call (360) 458-8411
as soon as possible.
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City ofVelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0165-VL
Issue Date 06/15/2005
(Work must be started within 180 days)
Receipt No
37013
Applicant:
Name: Evergreen State Builders
Phone:
253.475.6622
Address. P.O Box 39753
City' Lakewood
State: WA Zip 98499
PrClperw Information:
Site Address. 15804 Yelm Terra Way SE
Assessor Parcel No. 85840009400
Subdivision. Yelm Terra
Lot: 94
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
Pr()jectj!'lfQrlllation
Project: Yelm Terra
Description of Work: Plan 2200 /2A Lot 94
Sq. Ft. per floor' (1st) 1172
(2nd) 1028
(3rd) 480
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 1 301 19 993 75 307 44 5.6000 54 9000 $1,000
Building Plan Review 549 75 000 000 0.0000 o 0000
Mechanical Permit 8475 000 000 o 0000 0.0000
Plumbing Permit 118.00 20.00 98.00 7 0000 140000 Fixture
Sewer Inspection 145.00 0.00 14500 145.0000 1 0000 ERU
Water ERU 1,500 00 000 1,50000 1,500.0000 1 0000 ERU
Water Meter (SFO) 300.00 300 00 000 0.0000 0.0000
Water Deposit 40.00 4000 000 0.0000 o 0000
Traffic Facilities Charge 757.50 000 757 50 750 0000 1 0100 Peak PM Trip
Sewer Deposit 50.00 5000 0.00 o 0000 o 0000
State Building Fee 4.50 4.50 000 o 0000 o 0000
Sewer ERU 5,41700 000 5,41700 5,4170000 1 0000 ERU
TOTAL FEES. $10,267.69
App.li~~!'IJ's.Aff~ct~vit:
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,
easemen'tS"and restrictions of record. If applying as a contractor I futher certify that I am currently
:::::~ Oore 4>f,s/rP(
Firm eS~
# Sets of Prints.
Final Inspection:
Date: /2 -/5-~c>5-
;It!
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: Plan 2200 /2A Lot 94
Site Address. 15804 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 420120-344-85-00
Sewer Deposit 742402-389-01-00
State Building Fee 160001-386-00-00
Sewer ERU 802412-343-50-01
Permit No BLD-05-0165- YL
Phone.
253.475.6622
City' Lakewood
State. WA Zip 98499
Assessor Parcel No. 85840009400
Item Fee Base Amt Unit Fee Unit Rate No Units Unit Desc
----------
1 301 19 993.75 307 44 5.6000 54 9000 $1,000
549 75 000 000 o 0000 0.0000
8475 0.00 000 o 0000 o 0000
118.00 2000 98.00 7 0000 14 0000 Fixture
145 00 000 145.00 145 0000 1 0000 ERU
1,500.00 000 1 500 00 1,500.0000 1 0000 ERU
300.00 300 00 0.00 o 0000 0.0000
40.00 4000 0.00 0.0000 0.0000
757 50 000 757 50 750.0000 1 0100 Peak PM Trip
5000 50,00 0.00 o 0000 o 0000
450 4.50 000 0.0000 o 0000
5,417 00 0.00 5.417 00 5,417 0000 1 0000 ERU
RECEIPT No 370 13
RE9Fl~~N THOUSAND TWO HUNDRED SIXTY SEVEN DOLLARS
ix 69 CENTS
RECEIVED FROM
EVERGREEN STATE BUILDERS
POBOX 39753
LAKEWOOD WA 98499
SITE 15804 YELH TERRA WAY SE
BLD-05-016S-YL
DATE
06/15/05
REC. NO
37013
AMOUNT
10,267 69 CHECK
REF NO
PENDING
BUDGETARY
o q ~ &~
UICHELLE
B PMT1301 19,PLREV549 7S,MECH84 75,P~M118~,S~W~NS~1;5,IWTERU1500
DEP40 ,TRACHG757 50,SEHDEP50 0,STBLD!EE4 ::;0,.:>EHERUS",,1, 00
, I'lTHET 3013 ,vIT
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Yelm School District
ATTN SUSAN CROY
PO BOX 476
YELM, ~jA 98597
360-458-1900
Sold to 15755
EVERGREEN STATE BUILDERS LLC
56622
BUILDERS LLC EVERGREEN STATE
5516 75TH ST W #1
LAKEWOOD, WA 98499
# 6073 09 06/15/05
Reg #1 SalesPerson SUSAN
Item # 2900/MITIGATION
MITIGATION/CAPITAL PROJECTS
1 @ 6.844.00 6,844 00 7\.
4 CK #09865 FOR YELM TERRA LOTS 37,39,93~
SubTotal
6,844 00
Total Due
Check
6.844 00
6,844 00
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Thank you
PLEASE KEEP THIS RECEIPT" I
05/09/2005 15 05
253284:':1.1-83
U
CAS RES NWAF T~
PAGE 03/05
LOT '34
EVERGREEN STATE BUILDERS
YELM TERRA
YELM, WA
SITE PLAN .APPROVAL
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: YELM TERRA 51. SE
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WAITRLIN~ ~.-..c-- - ===-=-C;;l>'--=a-
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SEWER L1NE.---------- ---
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NORTH
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@ 200~- CASCADE RESIDENTIAI_ DF.:SIC~I, INC
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SCALE I' : 3~r
tHI~ DRAWING 15 SASF.O ON CLlENT-?ROVIOm INFORMATION RF.?RESENTEO TO BE ACCURATE
AND RELIABLE, MIl' lJlscR~P^NclES SHWEEN THIS MAWIND AND TH. AcTUAL SITE CONDITIONS
ARE HIE SOLE RESPONSI81L1TY OF THE CUENT
n SL 1'%# 0 /
Project Addratis:~~~Y6h ~~......y ~ar:eel #._A?t..~ ()~,dJ __
SUbdivis;on;l0'fh1. 1.€((tfL lot#._$Y~~ lOnrng;~~4t~f --({f111.1jj
'~ew Construdion U Re-Modell Re-.Roof I Addition u Home Occupation Sign
u Plumbing u Mechanical U Mobile I Manufactured Home Placement U Olher
Project Description/Scope of Work:~.fJ-'e +t.(/W.ll 0 f!e ~.( du.l (eLl
Project Value' cl..J ~ 7.s-tJ _._~.__
Building Area (sQ ft) 181 Floor.LL~ till FloorL~Z 8 Garage .:.t~O Deck
Basement Carport_.__Patio_~_
# Bedrooms~. # Bathrooms..? ,S- Hea!ln~THER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas locatad on the parcel? If yes, a
completed environmental checklist must accompany permIt application
BUIlDING CJVI!NfR NAME:JJ-- t-" , '~lfL $i;; ~ . ---I
ADDRI~~~,:S-:: ~l'... / '.r _EMAll L's" k:' r;.~tU~::t
CITY . STATE. lIP._-L. >~TElEPHO~=; ==~ '
ARCHITE('''TIENGJ~E')~~~~ICENSE#___ .: .]
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GENERAl CONTRACTOR. \W/IIIf1J) .ci.:$ {JJWLtlf" TELEPHONE__~ .: --=_
ADDRESS .._._____. _~,EMAll.. . ,
CllY STAlE ZIP FAX
CONTRACTORS LlC~SE #~l :r&f~~n~~XFDAT~CiTv .~CENSE # ,
pWMaING C9NTRl\\ilOR~~W ~1'ELEP,HONE~5:37-8',tjlJ a
ArJDRESS./8'18 ~o/;ffr'.i!iI- f? ~ EMAll
CITY 1?!lPiyMC--- STATE . zW"EW?'>-FAX;~ S",~ '"'s\~ 9U~ __
CONTRACTOR'S IJCEN~~ #'Z.=--..-.~--..,"- EX? DArE~CfTY LICENSE #
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.JELEPHON~ _
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ZIP F~
..~-=--EXPDA TE.~~_..crfv L1C~NSE #_.._.__
MECHANICAl CONTRACTOR_.....
AOORESS____
CITy.____.,_STATE
CONTRACTOR'S LICENSE #
Copy of mitigation agreement with Yelrn Community Schools, if applicabJo
I heMby certMy thul the 1l1l0YlI Infonl1atlon IItI &(If'l''lj(;! Illld tha1 thu cOl'l5trucilon Oil, ~mJ thl! ur:cuplllncy and thll use ofthe
abu\lfI descrlbed property will bIlln aCCUrd8YlCll wIth the lawH, rollllllimd (\!igldotlomi 01111" Stale of WS8hlngtoJ) and 'he
City of Yslm.
~~~ .___.. ___" ~-/J'-L>.;s-
AppJlcant's 8;9n8tu'''..._..--'-----. Date
Owner I Cc:mtructor~~~!!J!l Contractor', Agent {Please cir~11.l one.}
All permits are nonwtransferable and will G>>I.plre It work authorired by such permit is not begun
within 180 days of issuance, or If work is suspemded or abandoned for B period of 180 days
.........._-----_-..._.._~""-~--.~-_.-..
10,5 Yl!lm Avt!nut' West
PO 8oa: 479
YIl?Im, WA 98597
(360) 411lJ..38,fJ/J
(360) oItJII-3U4 FAX
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