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6/2005 ReportMemorandum City of Yelm Community Development Department P.O. Box 479 Yelm, WA 98597 (360) 458 -3835 (360) 458 -3144 FAX To: Thurston County Assessor and Thurston Regional Planning Council From: Roberta Allen, Administrative Assistant Date: July 5, 2005 Re: Building Permits Issued for the Month of June 2005 Enclosed are copies of the Building Permits issued. Permit numbers: BLD -05- 0028 -YL, 0052, 0150, 0151, 0155, 0156, 0159, 0162, 0165, 0166, 0167, 0168, 0170, 0171, 0172, 0173, 0176, 0177, 0185, FIRE -05- 0157 -YL SIGN -05- 0196 -YL If you have any questions, please contact Roberta Allen at (360) 458 -3835. Thank You, cc: Gary Carlson, Building Official R: \Building Folder\2005 Reports \06 -05 Permit Report.doc 0 City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458-3144 Applicant: Name: South Bay Homes Permit No: BLD -05- 0028 -YL Issue Date: 06110/2005 (Work must be started within 180 days) Receipt No: 36996 Phone: 943 -1362 Address: 115 N. McCormic City: Olympia State: WA Zip 98506 Property Information:. Site Address: 813 Yelm Avenue West Assessor Parcel No. 21724130800 Subdivision: N/A Lot: N/A Contractor Information: Name: Applicant Contact: Phone: Address: City: State: Zip: Contractor License No: Expires: Business License: Project Information: Project: Golden Dragon Description of Work: 3000 sf restaurant Sq. Ft. per floor: (1st) 3000 (2nd) 0 (3rd) 0 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 ----- -- - - -- 2,113.75 ----- - --- -- 993.75 ----- - - - --- 1,120.00 ----- - - - - -- 5.6000 -- --- 200.0000 $1,000 Building Plan Review 1,373.45 0.00 0.00 0.0000 0.0000 Mechanical Permit 84.80 0.00 0.00 0.0000 0.0000 Plumbing Permit 153.00 20.00 133.00 7.0000 19.0000 Fixture Sewer ERU 10,834.00 0.00 10,834.00 5,417.0000 2.0000 ERU Sewer Inspection 435.00 0.00 435.00 145.0000 3.0000 ERU Water ERU 4,500.00 0.00 4,500.00 1,500.0000 3.0000 ERU Water Deposit 200.00 40.00 0.00 0.0000 0.0000 Traffic Facilities Charge 13,792.50 0.00 13,792.50 750.0000 18.3900 Peak PM Trip Sewer Deposit 200.00 50.00 0.00 0.0000 0.0000 Sewer ERU (LID) 2,769.00 0.00 2,769.00 2,769.0000 1.0000 ERU Water Meter (Commercial) 300.00 300.00 0.00 0.0000 0.0000 State Building Fee 4.50 4.50 0.00 0.0000 0.0000 Water Meter (Irrigation) 400.00 300.00 0.00 0.0000 0.0000 TOTAL FEES: $37,160.00 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 # Sets of Prints: 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. Final inspection: Signature Firm Date Date: By. - �J 0 City Of Yelm Permit No: BLD -05- 0052 -YL Community Development Department Issue Date: 06/07/2005 Building Division (Work must be started within 180 days) Phone: (360) 458 -8407 Receipt No: 36932 Fax: (360) 458-3144 Applicant:. Name: PAR Homes Phone: 253 - 535 -6504 Address: 10749 South A St. City: Tacoma State: WA Zip 98444 Property Information: Site Address: 16234 Vancil Ct. SE Assessor Parcel No. Subdivision: Timber Estates Lot: 2 Contractor Information: Name: Applicnt Contact: Phone: Address: City: State: Zip: 98444 Contractor License No: Expires: Business License: Project Information: Project: Timber Estates Description of Work: 228813 Demo Sq. Ft. per floor: (1st) 1179 (2nd) 1109 Heat Type (Electric, Gas, Other): GAS Fees: Item Item Fee Building Permit 100 -500k 1,359.99 Building Plan Review 883.99 Mechanical Permit 78.25 Plumbing Permit 118.00 Sewer ERU 5,417.00 Sewer Inspection 145.00 Water ERU 1,500.00 Water Meter (SFD) 300.00 Water Deposit 40.00 Traffic Facilities Charge 757.50 Sewer Deposit 50.00 State Building Fee 4.50 TOTAL FEES: $10,654.23 Applicant's A_ffadavit: (3rd) 0 Garage 470 Basement 0 Base Amt Unit Fee Unit Rate No Units Unit Desc ----- - - - - -- 993.75 ----- - - - - -- 366.24 ----- - - - - -- 5.6000 ----- - - - - -- 65.4000 ------- - - - - -- $1,000 0.00 0.00 0.0000 0.0000 0.00 0.00 0.0000 0.0000 20.00 98.00 7.0000 14.0000 Fixture 0.00 5,417.00 5,417.0000 1.0000 ERU 0.00 145.00 145.0000 1.0000 ERU 0.00 1,500.00 1,500.0000 1.0000 ERU 300.00 0.00 0.0000 0.0000 40.00 0.00 0.0000 0.0000 0.00 757.50 750.0000 1.0100 Peak PM Trip 50.00 0.00 0.0000 0.0000 4.50 0.00 0.0000 0.0000 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 Firm Date Sets of Prints: Final. Inspection: Date: By: N� Applicant; City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Permit No: BLD -05- 0150 -YL Issue Date: 06/2012005 (Work must be started within 180 days) Receipt No: 37056 Name: Campbell, Lee Anne Phone: 458 -4443 Address: P.O. Box 1568 City: Yelm State: WA Zip 98597 Property Information: Site Address: 201 3rd Street NE Assessor Parcel No. Subdivision: Lot: Contractor I nformati on: Name: NW Custom Homes Contact: Phone: 360 - 446 -4111 Address: P.O. Box 670 City: Rainier State: WA Zip: 98576 Contractor License No: NORTHCH115NU Expires: 05/10/07130 Business License: Project Information: Project: Dr. Lee Anne Campbell Subdivision Description of Work: 1928 s.f. SFR Sq. Ft. per floor: (1st) 1072 (2nd) 856 (3rd) 0 Garage 439 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 ----- - - - - -- 1,430.55 ----- - - - - -- 993.75 ----- - - - - -- 436.80 ----- - - - - -- 5.6000 ----- - - - - -- 78.0000 ----- -- - - - - -- $1,000 Building Plan Review 929.85 0.00 0.00 0.0000 0.0000 Mechanical Permit 78.25 0.00 0.00 0.0000 0.0000 Plumbing Permit 118.00 20.00 98.00 7.0000 14.0000 Fixture Sewer Inspection 145.00 0.00 145.00 145.0000 1.0000 ERU Water Deposit 40.00 40.00 0.00 0.0000 0.0000 Traffic Facilities Charge 757.50 0.00 757.50 750.0000 1.0100 Peak PM Trip Sewer Deposit 50.00 50.00 0.00 0.0000 0.0000 State Building Fee 4.50 4.50 0.00 0.0000 0.0000 TOTAL FEES: $3,553.65 Applicant's Affadavit:_ 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 Firm Date OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: 0 0 Applicant: City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Permit No: BLD -05- 0151 -YL Issue Date: 06/20/2005 (Work must be started within 180 days) Receipt No: 37057 Name: Campbell, Lee Anne Phone: 458 -4443 Address: P.O. Box 1568 City: Yelm State: WA Zip 98597 Property Information: Site Address: 203 3rd Street NE Assessor Parcel No. Subdivision: Lot: Contractor Information: Name: NW Custom Homes Contact: Phone: 360 - 446 -4111 Address: P.O. Box 670 City: Rainier State: WA Zip: 98576 Contractor License No: NORTHCH115NU Expires: 05/10/07130 Business License: Project Information: _ Project: Dr. Lee Anne Campbell Subdivision Description of Work: 1516 s.f. SFR Sq. Ft. per floor: (1st) 807 (2nd) 709 (3rd) 0 Garage 518 Basement 0 Heat Type (Electric, Gas, Other): GAS Fees_: Item --------------------------- Building Permit 100 -500k Building Plan Review Mechanical Permit Plumbing Permit Sewer Inspection Water Deposit Traffic Facilities Charge Sewer Deposit State Building Fee Sewer ERU Water ERU Water Meter (SFD) TOTAL FEES: 4pplicant's Affidavit; Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc --- ---- - - - - -- ----- - - - - -- 1,248.55 --- -- - - - - -- 993.75 ----- - - - - -- 254.80 ----- - - -- -- 5.6000 ----- - - - - -- 45.5000 $1,000 . 811.55 0.00 0.00 0.0000 0.0000 78.25 0.00 0.00 0.0000 0.0000 97.00 20.00 77.00 7.0000 11.0000 Fixture 145.00 0.00 145.00 145.0000 1.0000 ERU 40.00 40.00 0.00 0.0000 0.0000 757.50 0.00 757.50 750.0000 1.0100 Peak PM Trip 50.00 50.00 0.00 0.0000 0.0000 4.50 4.50 0.00 0.0000 0.0000 5,417.00 0.00 5,417.00 5,417.0000 1.0000 ERU 1,500.00 0.00 1,500.00 1,500.0000 1.0000 ERU 300.00 300.00 0.00 0.0000 0.0000 $10,449.35 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 Firm Date # Sets of Prints: Final Inspection: Date: By: ONLY 0 0 City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458-3144 Applicant: Name: PAR Homes Address: 10749 South A St. Property Information: Site Address: 16308 Vancil Ct. SE Assessor Parcel No. Contractor Information: Name: Applicnt Address: Contractor License No: Project Information: Project: Timber Estates Description of Work: 2288/3 Permit No: BLD -05- 0155 -YL Issue Date: 06/07/2005 (Work must be started within 180 days) Receipt No: 36934 Phone: 253 -535 -6504 City: Tacoma State: WA Zip 98444 Subdivision: Timber Estates Contact: City: Expires: Sq. Ft. per floor: (1st) 1179 (2nd) 1109 (3rd) 0 Heat Type (Electric, Gas, Other): GAS Fees: Item Item Fee Base Amt Unit Fee ------------- -------- - - - - -- Building Permit 100 -500k ----- - - - - -- 1,359.99 ----- - - - --- 993.75 ----- - - - - -- 366.24 Building Plan Review 574.59 0.00 0.00 Mechanical Permit 78.25 0.00 0.00 Plumbing Permit 118.00 20.00 98.00 Sewer ERU 5,417.00 0.00 5,417.00 Sewer Inspection 145.00 0.00 145.00 Water ERU 1,500.00 0.00 1,500.00 Water Meter (SFD) 300.00 300.00 0.00 Water Deposit 40.00 40.00 0.00 Traffic Facilities Charge 757.50 0.00 757.50 Sewer Deposit 50.00 50.00 0.00 State Building Fee 4.50 4.50 0.00 TOTAL FEES: $10,344.83 Applicant's Affadavit: Lot: 4 Phone: State: Zip: 98444 Business License: Garage 470 Basement 0 Unit Rate No. Units Unit Desc ----- - - - - -- 5.6000 --- -- - - - - -- 65.4000 ------- - - - - -- $1,000 0.0000 0.0000 0.0000 0.0000 7.0000 14.0000 Fixture 5,417.0000 1.0000 ERU 145.0000 1.0000 ERU 1,500.0000 1.0000 ERU 0.0000 0.0000 0.0000 0.0000 750.0000 1.0100 Peak PM Trip 0.0000 0.0000 0.0000 0.0000 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 Firm Date OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: 0 0 0 City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Applicant: Name: PAR Homes Address: 10749 South A St. Permit No: BLD -05- 0156 -YL Issue Date: 06/07/2005 (Work must be started within 180 days) Receipt No: 36933 Phone: 253- 535 -6504 City: Tacoma State: WA Zip 98444 Property Information: _ Site Address: 16228 Vancil Ct. SE Assessor Parcel No. Subdivision: Timber Estates Lot: 1 Contractor Information: Name: PAR Homes Contact: , Craig Phone: 253 - 535 -6504 Address: 10749 South A St. City: Tacoma State: WA Zip: 98444 Contractor License No: PARHOI'972PT Expires: 03/0710766 Business License: Project Information: Project: Timber Estates Lot 1 Description of Work: Plan M3049133F -0 Sq. Ft. per floor: (1st) 1475 (2nd) 1574 (3rd) 0 Heat Type (Electric, Gas, Other): GAS Fees: Item --------------------------- Building Permit 100 -500k Building Plan Review Mechanical Permit Plumbing Permit Sewer ERU Sewer Inspection Water ERU Water Meter (SFD) Water Deposit Traffic Facilities Charge Sewer Deposit State Building Fee TOTAL FEES: Item Fee Base Amt Unit Fee 1,880.79 993.75 887.04 1,222.51 0.00 0.00 78.25 0.00 0.00 125.00 20.00 105.00 5,417.00 0.00 5,417.00 145.00 0.00 145.00 1,500.00 0.00 1,500.00 300.00 300.00 0.00 40.00 40.00 0.00 757.50 0.00 757.50 50.00 50.00 0.00 4.50 4.50 0.00 $11,520.55 0.0000 Garage 655 Basement 0 Unit Rate No. Units Unit Desc ----- - - - - -- 5.6000 ----- - - - - -- 158.4000 ------ -- - - - -- $1,000 0.0000 0.0000 0.0000 0.0000 7.0000 15.0000 Fixture 5,417.0000 1.0000 ERU 145.0000 1.0000 ERU 1,500.0000 1.0000 ERU 0.0000 0.0000 0.0000 0.0000 750.0000 1.0100 Peak PM Trip 0.0000 0.0000 0.0000 0.0000 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 # Sets'of Prints: 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. Final Inspection: Signature Firm Date Date: By: 0 0 City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458-3144 Applicant: Name: Yelm FFA Alumni Address: P.O. Box 557 City: Yelm Property Information: Site Address: 404 Yelm Ave West Permit No: BLD -05- 0159 -YL Issue Date: 06/08/2005 (Work must be started within 180 days) Receipt No: 36963 Phone: 458 -5290 State: WA Zip 98597 Assessor Parcel No. 75301000000 Subdivision: Lot: Contractor Information: Name: Contact: Phone: Address: City: State: Zip: Contractor License No: Expires: Business License: Project Information: Project: Yelm FFA Alumni Fireworks Stand Description of Work: Stand Number SN- 0001292 Permit Number 00480 Sq. Ft. per floor: (1st) 0 (2nd) 0 Heat Type (Electric, Gas, Other): OTHER (3rd) 0 Garage 0 Basement 0 Fees: Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc --------------------- - - - - -- -- --- - - - - -- ----- - - - - -- - ---- - - - - -- ----- - - - - -- ----- - - - - -- ------- - - - - -- Building Permit - Other 30.00 0.00 0.00 0.0000 0.0000 $1,000 TOTAL FEES: $30.00 Applicant's Affadavit: 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 Firm OFFICIAL USE ONLY #Sets of Prints: Final Inspection: Date: By: 0 City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Applicant: Name: Nisqually Valley Moose Address: City: Property Information: Site Address: 1117 Yelm Avenue West Assessor Parcel No. 21744120301 Subdivision: Contractor Information: Permit No: BLD -05- 0162 -YL Issue Date: 06/08/2005 (Work must be started within 180 days) Receipt No: 36961 Lot: Name: Applicant Contact: Phone: Address: City: State: Zip: Contractor License No: Expires: Business License: Project Information: Project: Nisqually Valley Moose Reroof Description of Work: Tear off and reroof Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0 Heat Type (Electric, Gas, Other): Garage 0 Fees: Item Item Fee Base Amt Unit Fee Unit Rate -- ----- ----------- --- - -- - -- ----- - - - - -- -- --- - - - - -- ----- - - - - -- --- -- - - - - -- Building Permit - Other 125.25 0.00 0.00 0.0000 TOTAL FEES: $125.25 Applicant's Affadavit: Basement 0 No. Units Unit Desc ----- - - - - -- ------- - - - - -- 0.0000 $1,000 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 Firm # Sets of Prints: Final Inspection: Date: By: 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 City: Lakewood Permit No: BLD -05- 0165 -YL Issue Date: 06/15/2005 (Work must be started within 180 days) Receipt No: 37013 Phone: 253.475.6622 State: WA Zip 98499 Property 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: 10102/06275 Business License: 1042.0 Project Information: _ 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 0.00 0.00 0.0000 0.0000 Mechanical Permit 84.75 0.00 0.00 0.0000 0.0000 Plumbing Permit 118.00 20.00 98.00 7.0000 14.0000 Fixture Sewer Inspection 145.00 0.00 145.00 145.0000 1.0000 ERU Water ERU 1,500.00 0.00 1,500.00 1,500.0000 1.0000 ERU Water Meter (SFD) 300.00 300.00 0.00 0.0000 0.0000 Water Deposit 40.00 40.00 0.00 0.0000 0.0000 Traffic Facilities Charge 757.50 0.00 757.50 750.0000 1.0100 Peak PM Trip Sewer Deposit 50.00 50.00 0.00 0.0000 0.0000 State Building Fee 4.50 4.50 0.00 0.0000 0.0000 Sewer ERU 5,417.00 0.00 5,417.00 5,417.0000 1.0000 ERU TOTAL FEES: $10,267.69 Applicant's Affadayit: 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 Firm Date Final Inspection: Date: By: 0 0 City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458-3144 Permit No: BLD -05- 0166 -YL Issue Date: 06/15/2005 (Work must be started within 180 days) Receipt No: 37014 Applicant: Name: Evergreen State Builders Phone: 253 -475 -6622 Address: P.O. Box 39753 City: Lakewood State: WA Zip 98499 Property Information: Site Address: 15788 Yelm Terra Way SE Assessor Parcel No. 85840009300 Contractor Information: Subdivision: Yelm Terra Lot: 93 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 2502 S /2, Lot 93 Sq. Ft. per floor: (1st) 1034 (2nd) 1467 (3rd) 461 Garage 0 Heat Type (Electric, Gas, Other): GAS Fees: Item --------------------------- Building Permit 100 -500k Building Plan Review Mechanical Permit Plumbing Permit Sewer Inspection Water ERU Water Meter (SFD) Water Deposit Traffic Facilities Charge Sewer Deposit State Building Fee Sewer ERU TOTAL FEES: Applicant's Affadavit: Item Fee Base Amt Unit Fee Unit Rate -- --- - - - - -- 1,408.90 - ---- - -- - -- 993.75 ----- - - - - -- 415.15 --- -- - - - --- 5.6000 595.26 0.00 0.00 0.0000 78.75 0.00 0.00 0.0000 132.00 20.00 112.00 7.0000 145.00 0.00 145.00 145.0000 1,500.00 0.00 1,500.00 1,500.0000 300.00 300.00 0.00 0.0000 40.00 40.00 0.00 0.0000 757.50 0.00 757.50 750.0000 50.00 50.00 0.00 0.0000 4.50 4.50 0.00 0.0000 5,417.00 0.00 5,417.00 5,417.0000 $10,428.91 Basement 0 No. Units Unit Desc 74.1340 $1,000 0.0000 0.0000 16.0000 Fixture 1.0000 ERU 1.0000 ERU 0.0000 0.0000 1.0100 Peak PM Trip 0.0000 0.0000 1.0000 ERU 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 Firm Date # Sets of Prints: Final Inspection: Date: By: ONLY 0 0 _1\ Applicant: City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Permit No: BLD -05- 0167 -YL Issue Date: 06/15/2005 (Work must be started within 180 days) Receipt No: 37016 Name: Evergreen State Builders Phone: 253 -475 -6622 Address: P.O. Box 39753 City: Lakewood State: WA Zip 98499 Property Information: Site Address: 15744 104th Ave SE Assessor Parcel No. 85840003900 Subdivision: Yelm Terra Lot: 39 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 1818 Sl2 Lot 39 Sq. Ft. per floor: (1st) 547 (2nd) 1271 (3rd) 585 Garage 585 Basement 0 Heat Type (Electric, Gas, Other): GAS Fees: Item --------------------------- Building Permit 100 -500k Building Plan Review Mechanical Permit Plumbing Permit Sewer Inspection Water ERU Water Meter (SFD) Water Deposit Traffic Facilities Charge Sewer Deposit State Building Fee Sewer ERU TOTAL FEES: Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc -- --- - - - - -- 1,175.58 ----- - --- -- 993.75 ----- - - - - -- 181.83 -- --- - - - - -- 5.6000 ----- - - - - -- 32.4700 ------- - - - - -- $1,000 496.68 0.00 0.00 0.0000 0.0000 78.75 0.00 0.00 0.0000 0.0000 132.00 20.00 112.00 7.0000 16.0000 Fixture 145.00 0.00 145.00 145.0000 1.0000 ERU 1,500.00 0.00 1,500.00 1,500.0000 1.0000 ERU 300.00 300.00 0.00 0.0000 0.0000 40.00 40.00 0.00 0.0000 0.0000 757.50 0.00 757.50 750.0000 1.0100 Peak PM Trip 50.00 50.00 0.00 0.0000 0.0000 4.50 4.50 0.00 0.0000 0.0000 5,417.00 0.00 5,417.00 5,417.0000 1.0000 ERU $10,097.01 Applicant's Affadavit: 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 Firm Date # Sets of Prints: Final inspection: Date: By: 0 0 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 City: Lakewood Permit No: BLD -05- 0168 -YL Issue Date: 06/15/2005 (Work must be started within 180 days) Receipt No: 37017 Phone: 253 -475 -6622 State: WA Zip 98499 Property Information: Site Address: 15732 104th Ave SE Assessor Parcel No. 85840003700 Subdivision: Yelm Terra Lot: 37 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: 10102/06275 Business License: 1042.0 Project information; Project: Yelm Terra Description of Work: Plan 1818 S/2 Lot 37 Sq. Ft. per floor: (1st) 547 (2nd) 1271 (3rd) 585 Garage 0 Basement 0 Heat Type (Electric, Gas, Other): GAS Fees: Item --------------------------- Building Permit 100 -500k Building Plan Review Mechanical Permit Plumbing Permit Sewer Inspection Water ERU Water Meter (SFD) Water Deposit Traffic Facilities Charge Sewer Deposit State Building Fee Sewer ERU TOTAL FEES Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc ----- - - - - -- 1,175.58 -- --- - - - - -- 993.75 ----- - - - - -- 181.83 ----- - - - --- 5.6000 - ---- - - - - -- 32.4700 ------- - - - - -- $1,000 496.68 0.00 0.00 0.0000 0.0000 78.75 0.00 0.00 0.0000 0.0000 132.00 20.00 112.00 7.0000 16.0000 Fixture 145.00 0.00 145.00 145.0000 1.0000 ERU 1,500.00 0.00 1,500.00 1,500.0000 1.0000 ERU 300.00 300.00 0.00 0.0000 0.0000 40.00 40.00 0.00 0.0000 0.0000 757.50 0.00 757.50 750.0000 1.0100 Peak PM Trip 50.00 50.00 0.00 0.0000 0.0000 4.50 4.50 0.00 0.0000 0.0000 5,417.00 0.00 5,417.00 5,417.0000 1.0000 ERU $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 # Sets of Prints: 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. Final Inspection: Signature Firm Date Date: By: 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 City: Lakewood F rop_e_rty Information: Site Address: 15782 Yelm Terra Way SE Assessor Parcel No. 85840009200 Subdivision: Yelm Terra Permit No: BLD -05- 0170 -YL Issue Date: 06115/2005 (Work must be started within 180 days) Receipt No: 37015 Phone: 253 -475 -6622 State: WA Zip 98499 Lot: 92 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: 10102/06275 Business License: 1042.0 Project Information: Project: Yelm Terra Description of Work: 1675/3 Lot 92 Sq. Ft. per floor: (1st) 908 (2nd) 767 (3rd) 0 Heat Type (Electric, Gas, Other): GAS Fees: Item _ --------------------------- Building Permit 100 -500k Building Plan Review Mechanical Permit Plumbing Permit Sewer Inspection Water ERU Water Meter (SFD) Water Deposit Traffic Facilities Charge Sewer Deposit State Building Fee Sewer ERU TOTAL FEES: Applicant's Affadavit: Item Fee Base Amt Unit Fee 1,149.15 993.75 155.40 485.66 0.00 0.00 78.25 0.00 0.00 118.00 20.00 98.00 145.00 0.00 145.00 1,500.00 0.00 1,500.00 300.00 300.00 0.00 40.00 40.00 0.00 757.50 0.00 757.50 50.00 50.00 0.00 4.50 4.50 0.00 5,417.00 0.00 5,417.00 $10,045.06 1.0000 ERU Garage 413 Basement 0 Unit Rate No. Units Unit Desc ----- - - - - -- 5.6000 ----- - - - - -- 27.7500 -- ----- - - - - -- $1,000 0.0000 0.0000 0.0000 0.0000 7.0000 14.0000 Fixture 145.0000 1.0000 ERU 1,500.0000 1.0000 ERU 0.0000 0.0000 0.0000 0.0000 750.0000 1.0100 Peak PM Trip 0.0000 0.0000 0.0000 0.0000 5,417.0000 1.0000 ERU 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 Firm Date OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: 0 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 City: Lakewood Permit No: BLD -05- 0171 -YL Issue Date: 06/28/2005 (Work must be started within 180 days) Receipt No: 37125 Phone: 253 -475 -6622 State: WA Zip 98499 Property,lnformation: 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 nformation: Project: Yelm Terra Description of Work: 1675/3 Lot 97 Sq. Ft. per floor: (1st) 908 (2nd) 767 (3rd) 0 Heat Type (Electric, Gas, Other): GAS Fees: Item - - --------------------------- Building Permit 100 -500k Building Plan Review Mechanical Permit Plumbing Permit Sewer Inspection Water ERU Water Meter (SFD) Water Deposit Traffic Facilities Charge Sewer Deposit State Building Fee Sewer ERU TOTAL FEES: Item Fee Base Amt Unit Fee ----- - - - - -- 1,149.15 ----- - - - - -- 993.75 - ---- - - - - -- 155.40 485.66 0.00 0.00 78.25 0.00 0.00 118.00 20.00 98.00 145.00 0.00 145.00 1,500.00 0.00 1,500.00 300.00 300.00 0.00 40.00 40.00 0.00 757.50 0.00 757.50 50.00 50.00 0.00 4.50 4.50 0.00 5,417.00 0.00 5,417.00 $10,045.06 Garage 413 Basement 0 Unit Rate No. Units Unit Desc ---- - - - - - -- 5.6000 ----- - - - - -- 27.7500 ------- -- - - -- $1,000 0.0000 0.0000 0.0000 0.0000 7.0000 14.0000 Fixture 145.0000 1.0000 ERU 1,500.0000 1.0000 ERU 0.0000 0.0000 0.0000 0.0000 750.0000 1.0100 Peak PM Trip 0.0000 0.0000 0.0000 0.0000 5,417.0000 1.0000 ERU 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 # Sets of Prints: 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. Final Inspection: Signature Firm Date Date: By: 0 City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458-3144 Applicant: _ Name: Evergreen State Builders Address: 3815 100th St. SW, Ste 2A City: Lakewood Property Information: Site Address: 15816 Yelm Terra Way SE Assessor Parcel No. 85840009600 Permit No: BLD -05- 0172 -YL Issue Date: 06/28/2005 (Work must be started within 180 days) Receipt No: 37126 Phone: 253.475.6622 State: WA Zip 98499 Subdivision: Yelm Terra Lot: 96 Contractor information: Name: Evergreen State Builders Contact: McCullem, Tom Phone: 253 -475 -6622 Address: P.O. Box 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: (1st) 854 (2nd) 952 Heat Type (Electric, Gas, Other): GAS Fees: Item Item Fee Building Permit 100 -500k 1,149.15 Building Plan Review 485.51 Mechanical Permit 78.75 Plumbing Permit 111.00 Sewer Inspection 145.00 Water ERU 1,500.00 Water Meter (SFD) 300.00 Water Deposit 40.00 Traffic Facilities Charge 757.50 Sewer Deposit 50.00 State Building Fee 4.50 Sewer ERU 5,417.00 TOTAL FEES: $10,038.41 Applicant's Affadav_t; 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. (3rd) 418 Garage 0 Basement 0 Base Amt Unit Fee Unit Rate No. Units Unit Desc - -- - -- ----- - - - - -- 993.75 ----- - -- - -- 155.40 ---- - - - - - -- 5.6000 ----- - - - --- 27.7500 ------- $1,000 0.00 0.00 0.0000 0.0000 0.00 0.00 0.0000 0.0000 20.00 91.00 7.0000 13.0000 Fixture 0.00 145.00 145.0000 1.0000 ERU 0.00 1,500.00 1,500.0000 1.0000 ERU 300.00 0.00 0.0000 0.0000 40.00 0.00 0.0000 0.0000 0.00 757.50 750.0000 1.0100 Peak PM Trip 50.00 0.00 0.0000 0.0000 4.50 0.00 0.0000 0.0000 0.00 5,417.00 5,417.0000 1.0000 ERU Signature Firm Date FOFFICIAL USE O NLY of Prints: Final Inspection: Date: By: P p THFp City of Yelm 9�` Community Development Department a ON FaxBuilding Division Phone: (360) 458 -8407 YELM : (360) 458 -3144 Applicant: Permit No: BLD -05- 0173 -YL Issue Date: 06/17/2005 (Work must be started within 180 days) Receipt No: 37051 Name: Brown Car Care Phone: 458 -1421 Address: 15711 92nd Way SE City: Yelm State: WA Zip 98597 Property Information: Site Address: 16510 106th Ave SE Assessor Parcel No. 99002046289 Subdivision: Lot: Contractor Information: Name: Contact: Phone: Address: City: State: Zip: Contractor License No: Expires: Business License: Project_lnformation; _ Project: Brown's Automotive Expansion Description of Work: 3760 sf expansion Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0 Heat Type (Electric, Gas, Other): Fees: Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc ----- - - - - -- ------- - - - - -- ---- ----------------- -- - - -- Building Permit 100 -500k ----- - - -- -- 1,049.75 ----- - - - - -- 993.75 ----- - - - - -- 56.00 ----- - - - - -- 5.6000 10.0000 $1,000 Building Plan Review 682.33 0.00 0.00 0.0000 0.0000 State Building Fee 4.50 4.50 0.00 0.0000 0.0000 Mechanical Permit 39.00 0.00 0.00 0.0000 0.0000 TOTAL FEES: $1,775.58 Applicant's Affadavit 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 Firm ONLY # Sets of Prints: I Final Inspection: Date: By: 0 Applicant: City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458-3144 Permit No: BLD -05- 0176 -YL Issue Date: 06/28/2005 (Work must be started within 180 days) Receipt No: 37129 Name: Evergreen State Builders Phone: 253 -475 -6622 Address: P.O. Box 39753 City: Lakewood State: WA Zip 98499 Property Information: Site Address: 15731 104th Ave SE Assessor Parcel No. 85840007600 Subdivision: Yelm Terra Lot: 76 Contractor Information: Name: Evergreen State Builders Contact: McCullem, Tom Phone: 253 -475 -6622 Address: P.O. Box 197 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 1610 R/2B , Lot 76 Sq. Ft. per floor: (1st) 1610 (2nd) 0 (3rd) 0 Garage 470 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 -- --- - - -- -- 1,090.90 ----- - - - - -- 993.75 ----- - - - - -- 97.15 ----- - - - - -- 5.6000 - ---- - - - - -- 17.3490 $1,000 Building Plan Review 460.90 0.00 0.00 0.0000 0.0000 Mechanical Permit 71.75 0.00 0.00 0.0000 0.0000 Plumbing Permit 111.00 20.00 91.00 7.0000 13.0000 Fixture Sewer Inspection 145.00 0.00 145.00 145.0000 1.0000 ERU Water ERU 1,500.00 0.00 1,500.00 1,500.0000 1.0000 ERU Water Meter (SFD) 300.00 300.00 0.00 0.0000 0.0000 Water Deposit 40.00 40.00 0.00 0.0000 0.0000 Traffic Facilities Charge 757.50 0.00 757.50 750.0000 1.0100 Peak PM Trip Sewer Deposit 50.00 50.00 0.00 0.0000 0.0000 State Building Fee 4.50 4.50 0.00 0.0000 0.0000 Sewer ERU 5,417.00 0.00 5,417.00 5,417.0000 1.0000 ERU TOTAL FEES: $9,948.55 Applica nt'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 # Sets of Prints: 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. Final Inspection: Signature Firm Date Date: By: City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458-3144 Applicant: Name: Evergreen State Builders Address: 3815 100th St. SW, Ste. 2A Property Information: Site Address: 15734 Yelm Terra Way SE Assessor Parcel No. 85840008600 Contractor Information: Name: Evergreen State Builders Address: P.O. Box 39753 Contractor License No: EVERGSB980PB Project_ Information; Project: Yelm Terra Description of Work: Plan 221112, Lot 86 City: Lakewood Permit No: BLD -05- 0177 -YL Issue Date: 06/28/2005 (Work must be started within 180 days) Receipt No: 37128 Phone: 253.475.6622 State: WA Zip 98499 Subdivision: Yelm Terra Lot: 86 Contact: McCullem, Tom Phone: 253 -475 -6622 City: Lakewood State: WA Zip: 98499 Expires: 10102106275 Business License: 1042.0 Sq. Ft. per floor: (1st) 1071 (2nd) 1140 (3rd) 0 Heat Type (Electric, Gas, Other): GAS Fees: No. Units Unit Desc ----- - - - - -- 5.6000 Item Item Fee Base Amt Unit Fee --------------------- - - - - -- Building Permit 100 -500k ----- - - - - -- 1,299.32 ----- - - - - -- 993.75 ----- - - - - -- 305.57 Building Plan Review 548.96 0.00 0.00 Mechanical Permit 78.75 0.00 0.00 Plumbing Permit 125.00 20.00 105.00 Sewer Inspection 145.00 0.00 145.00 Water ERU 1,500.00 0.00 1,500.00 Water Meter (SFD) 300.00 300.00 0.00 Water Deposit 40.00 40.00 0.00 Traffic Facilities Charge 757.50 0.00 757.50 Sewer Deposit 50.00 50.00 0.00 State Building Fee 4.50 4.50 0.00 Sewer ERU 5,417.00 0.00 5,417.00 TOTAL FEES: $10,266.03 ApplicanVs_Affadavit: 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. Garage 434 Basement 0 Unit Rate No. Units Unit Desc ----- - - - - -- 5.6000 ----- - - - - -- 54.5660 -- ----- - -- - -- $1,000 0.0000 0.0000 0.0000 0.0000 7.0000 15.0000 Fixture 145.0000 1.0000 ERU 1,500.0000 1.0000 ERU 0.0000 0.0000 0.0000 0.0000 750.0000 1.0100 Peak PM Trip 0.0000 0.0000 0.0000 0.0000 5.417.0000 1.0000 ERU Signature Firm Date OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: Applicant; City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458-3144 Permit No: BLD -05- 0185 -YL Issue Date: 06/28/2005 (Work must be started within 180 days) Receipt No: 37127 Name: Evergreen State Builders Phone: 253 -475 -6622 Address: P.O. Box 39753 City: Lakewood State: WA Zip 98499 Property Information: Site Address: 15776 Yelm Terra Way SE Assessor Parcel No. 85840009100 Subdivision: Yelm Terra Lot: 91 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 1819/2, Lot 91 Sq. Ft. per floor: (1st) 1363 (2nd) 658 (3rd) 0 Heat Type (Electric, Gas, Other): GAS Fees: Item . --------------------------- Building Permit 100 -500k Building Plan Review Mechanical Permit Plumbing Permit Sewer Inspection Water ERU Water Meter (SFD) Water Deposit Traffic Facilities Charge Sewer Deposit State Building Fee Sewer ERU TOTAL FEES: Applicant's --- 0vit: _ 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. Item Fee Base Amt ----- - - - - -- ----- - - - - -- 1,282.71 993.75 542.02 Unit Rate 0.00 84.75 ----- - -- - -- 288.96 0.00 132.00 ------- - - - - -- $1,000 20.00 145.00 0.0000 0.00 1,500.00 0.0000 0.00 300.00 112.00 300.00 40.00 Fixture 40.00 757.50 1.0000 0.00 50.00 1,500.0000 50.00 4.50 0.00 4.50 5,417.00 0.00 $10,255.48 0.0000 Garage 440 Basement 0 Unit Fee Unit Rate No. Units Unit Desc ----- - -- - -- 288.96 ----- - - - - -- 5.6000 - ---- - - - --- 51.6000 ------- - - - - -- $1,000 0.00 0.0000 0.0000 0.00 0.0000 0.0000 112.00 7.0000 16.0000 Fixture 145.00 145.0000 1.0000 ERU 1,500.00 1,500.0000 1.0000 ERU 0.00 0.0000 0.0000 0.00 0.0000 0.0000 757.50 750.0000 1.0100 Peak PM Trip 0.00 0.0000 0.0000 0.00 0.0000 0.0000 5,417.00 5,417.0000 1.0000 ERU Signature Firm Date OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: 0 City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Permit No: FIRE -05- 0157 -YL Issue Date: 06/06/2005 (Work must be started within 180 days) Receipt No: 36904 Applicant: Name: Nisqually Valley Moose Phone: 458 -3381 Address: P.O. Box 757 City: Yelm State: WA Zip 98597 Property Information: Site Address: 1117 Yelm Avenue West Assessor Parcel No. 21744120301 Subdivision: Lot: Contractor Information: Name: Contact: Phone: Address: City: State: Zip: Contractor License No: Expires: Business License: Project_ Information: Project: Nisqually Valley Moose Description of Work: Fireworks Stand Number Sn- 0001119 License #00224 Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0 Heat Type (Electric, Gas, Other): Fees Item. --------------------------- Building Permit - Other TOTAL FEES: Applicant's Affadavit: 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 Item Fee Base Amt Unit Fee ----- - - - - -- ----- - - - - -- ----- - - - - -- 30.00 0.00 0.00 $30.00 Unit Rate No. Units Unit Desc ----- - - - - -- ----- - - - - -- ------- - - - - -- 0.0000 0.0000 $1,000 Firm OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: 0 0 City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Permit No: SIGN -05- 0196 -YL Issue Date: 06/27/2005 (Work must be started within 180 days) Receipt No: Applicant: _ Name: John L. Scott Real Estate Phone: Address: P.O. Box 559 City: Yelm State: Wa Zip 98597 Property Information: Site Address: 1202 Yelm Ave. East. Assessor Parcel No. 22730110103 Subdivision Contractor Information: Name: Signco Address: P.O. Box 430 Contractor License No: Project Information:_ Project: John L Scott Sign Description of Work: John L. Scott Sign Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0 Heat Type (Electric, Gas, Other): OTHER Lot: Contact: Steimert, Dick Phone: 360- 794 -8614 City: Monroe State: Wa Zip: 98272 Expires: Business License: apollino440d Garage 0 Basement 0 Fees: Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc ----------------- ---- - - - - -- - ---- - - - - -- ---- - - - - - -- ----- - - - - -- ---- -- - - - -- ----- -- - - -- ------ - - - - - -- Building Permit - Other 20.00 0.00 0.00 0.0000 0.0000 $1,000 TOTAL FEES: $20.00 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 # Sets of Prints: 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. Final Inspection: Signature Firm Date Date: By: