BLD-05-0598oe *"P City of Yelm Permit NO: BLD-05-0598-YL
A~ Community Development Department Issue Date: O6/ib/200fi
(Work must be started within 18D days)
Building Division
Phone: 1369)468.8407 Receipt NO: 42391
Y LM Fax: 1760)496-3144
Applicant: Ote ~,
Name: B&N Builders Phone: 468-3277
Address: P.O. Box 1959 City: Yelm State: WA Zip 98697
Property I_FOrmation: -~
Ske Address: 211 Yelm Ave. West
Assessor Parcel NC. 85800300000 Subdivision: Lot:
Contractor Information:
Name: BSR Builders Contatl: Hunt, David Phone: 458-3277
Address: P.O. BOx 1999 City: Velm State: WA Zip: 9889]
Conlrador License No: BNBUII'093C6 Expires: 0 710110 71 8 2 Business License:
Project Infortnation_ --'
Project: Brock Chiropractic
Description of Work: Interior Remodel of Residence
to Medical Office
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-Other 294.00 0.00 0.00 0.0000 0.0000 $1,000
Building Plan Review 191.10 0.00 0.00 0.0000 0.0000
Mechanical Permit 33.25 0.00 0.00 0.0000 0.0000
TOTAL FEES: b618.36
I certiry 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 sVUqure is in conformity with all applicable City of
Velm regulations including those gov@ming zoning and land sub0ivisioq and in atlditi0n all covenants,
easements and restrictions of record. If apprying as a contractor, I futher cediry that 1 am currently
registered in the State of Washington.
Date [{I ~ // ~ ~ ~
Firm
# Sets of Prints: -
Final lnspectlon:
Date:'
By:
CYTY OF
YELM
P.O. Rax 4]9
Yelm, WA 985W
360-05&8403
RECEIVED .+++pIyE HUNDRED EIGHTEEN DOLLARS fi 35 CENTS
RECEIVED FROM DATE REC. NO.
S6H BUILDERS 06/14/06 42391
PO BO% 1959
YELH, NA 98597 BUDGETARY
BLD-05-0598-YL
SITES 211 YELM AVE N
DIANA
RECEIPT No. Q 23 91
AMOUNT REF NO.
518.35 CHECE 7900
~o TBep~~ City of Yelm
y Community Development Department
i m
Builtling Division
Phone: 13601456-640]
YELM Faz: (360)466-3144
Applicant: ~ ~ -~
Name: BSH Builders
Atldress: P.O. Boz 1969 Cily: Yplm
Project Information:
Project: Brock Chiropactic
Description of Wark: Interior Remotlel of Residence
to Medical Office
Site Adtlress: 211 Yelm Ave. West
Fees
Item Acct Cotle
Builtling Permit-Other 032001-322-10-00
Building Plan Review 100 001-345-63-00
Mechanical Permit 032 001-322-10-00
TOTAL FEES:
Permit Fees Schedule
,Permit NO: BLD-05-0598-YL
Phone. 469-32]9
State: WA Zip 9659]
Assessor Parcel NO. 85800300400
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
29d.00 0.00 0.00 0.0000 0.0000 $1,000
191.10 0.00 0.00 0.0000 0.0000
33.25 0.00 0.00 0.0000 0.0000
E616.35
i
Received
MAY 1 7 2006
cfrv oP rFiM
COMMIERCW. BUIlDINO PERNIR APP4CA71ON FORM
ProleceAdaress;~ll ~I-~mHJc.~i- Parcel n: 85 Soo.3opt1-o0
Zoning: Current USe: Proposed Use: '
0 New COnstnactlon ~Re-Model/Re-ROOF/Tenerd Improvement
^ PlumMng ^ MechaNCal O Fire Prevern/Suppress/Alertn ^ Other
Project Descdption/3copa of Work: Twf~~`':'"WY1~~5 -/JA/J /SN~li-~UY~~i~':w-~CCIB~-9~~R~'nP /lurk
Project value: ~3ODO p0
F F
Buikfing Area (sq. fU Parkbg Garage tr1 Floor 70 ~? p^r Floor_g1° Flaor_
BuilUing Helght ~~ '
Ara there any environmenlelly aenagive areas boated on the parcel? Nn It yes, a
crnnpleted enWronmental checklist must accompany perms appOcatbn.
^_CaPYeI Gry MNgatlon amummgdart QFCj.
1 harabYaratY Net the above inlormaaon b rmrM wltl that Lhs wnabueaen m, entl Na saeWenaY Ma a» uss
of the above aesttibea property wN be in aecmtlmee wIM Ma lawn, mlea tmE regWatlene et tlw 6tets of
WasNnptan an NY<tm.
Applirant'a Signature Date
OwnerlContractorlOwner's Agent/Contrector's Agerd/Tenant (Please circle one.)
All permas aronon-transtereble end ~m71 nxpiro N work authorized by such permit is not
begun within 180 days of issuance, or if work is suspended or abandoned for a period of
1a0 days
600/Z00'd GOOed 661fi 856 098 A30 Y6AJ-Wl3A d0 A11J 60:60 8002-O1-NlIP
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General/Specialty Contractor
A business registered as a construction contractor with Lftl [o perform construction work within the scope
of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment
of account and carry general liability insurance.
License Information
License BHBUII'093C6
Licensee Name B & H BUILDERS INC
F Licensee Type CON57RUCTION CONTRACTOR
UBI 601270968 Verify WorkeriC2mp Pre i m
Status
Ind. Ins. Accou d 80063600
Business Type CORPORATION
Address 1 PO BO% 1959
Address 2
Ciry YELM
County THURSTON
State WA
Zip 98597
Phone 3604583277
Status ACTIVE
Specialty 1 GENERAL
Specialty 2 UNUSED
Effective Date 2/26/1991
Exptration Date 7/1/2007
Suspend Date
Separation Date
Parent Company
Previous License WESTCC'194PZ
Next License
Associated
License
https://fortress.wa.gov/Ini/bbip/Detail.aspx?License=BHBUII'093C6 6/6/2006
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Business Owner Information ~
Name Role Effective Date Expiration Date
'~. BADGER, BRADLEY E 01/01/1980
''.. HUNT, DAVID B 01/01/1980
''.. BADGER, SHELLY A 01/01/1980
''.. BADGER, SHELLY A AGENT 01/01/1980
Bond Information ''
Band Bond
Company Account Effective Expiration Cancel Impaired Bond Received
Bond Name Number Dale Date Date Date Amount Date
AMERICAN
STATES Until
#d INS CO 6068345 01/18/2002 Cancelled $12,000.00 12/03/2001
AMERICAN
STATES
#5 INS CO 6068345 01/18/2001 01/18/2002 $6,000.00 12/27/2000
COLONIAL
AM CAS 8
SURETY Until
#4 OF MD LPM4049259 01/18/2000 Cancelled 01/18/2001 $6,000.00
STAR INS Until
#3 CO SA5071381 01/18/1998 Cancelled 01/18/2000 $6,000.00
STAR INS
#2 CO SA5071381 01/18/1996 01/18/1998 $6,000.00
#1 CBIC 629685 01/18/1991 01/18/1996 $6,000.00
Savings Information
No Matching Information
Insurance Information
Company Effective Expiration Cancel Impaired Recei~
Insurance Name Policy Number Date Date Date Date Amount Dat
NATIONAL
FIRE &
#12 MARINE INC 72LPE702698 07/15/2005 07/15/2006 $1,000,000.00 07/15/
NATIONAL
FIRE &
MARINE INS
#11 CO 72LPE695342 07/15/2004 07/15/2005 $1,000,000.00 07/15/
NATIONAL
FIRE &
MARINE INS
~,#10 CO 72LPE690245 07/15/2003 07/15/2004 $1,000,000.00 07/16/
NATIONAL
FIRE E
A9 MARINE 72LP148217 07/15/2002 07/15/2003 $1,000,000.00 08/16/
TRAVELERS Until
#8 INS CO 1680254L1806 07/01/1998 Cancelled
I
https://fortress.wa.gov/Ini/bbip/Detail.aspx?License=BHBUII*093C6 6/6/2006
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AETNA CAS
& SURELY
N7 CO 081MP0026043829 07/01/1997 07/01/1998
AETNA
CASUALTY &
q6 SURETY CO MP0025567022 07/01/1996 07/01/1997
FARMINGTON
CASUALTY
#5 CO MP24907884 07/01/1995 07/01/1996
FARMINGTON
b4 CASUALTY 081MP0024202914 07/01/1994 07/01/1995
AETNA
q3 CASUALTY 081 MP0022533820TWF 07/01/1992 07/01/1994
AETNA
N2 CASUALTY 081 MP0021467705TWF 07/01/1991 07/01/1992
AETNA
'!ii CASUALTY 081MP20344742 07/01/1990 07/01/1991
Summons /Complaints Information
No Matching Information
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5lalf mly linty
https://fortress.wa.gov/lni/bhip/Detail.aspx?License=BHBUII*093C6 6/6/2006
PERMIT4
APPROVED
~ ot+c ~a ~ ., ,.~ ~ „~~,2[ ht
~., Olympic Region Clean Air Agency NOT APPROVED.
2940-B Llmlted Lane NW FOR COMPEIANCE WITH
~.~i ~ Olympl8, WA 98502 ORCAA REGULATION 1
`v. ORCAA ~ (360) 586-1044 or 1-800 422-5623 ~
~~b'ti ~'' Fax: (360) 491-6308 hnvw.ORCAA.org
~Mr~snue»,.iwan".
Notification of Demolition Permit
fs is unlflwfui (or any pereon b souse or allow she de~nolilion (or major vosion) of any elnuYUre unless all asbenne-
comaiuingmeterldshavebeenrunovulfromthearulobedemoUahed Werh slmll nos commence on an ubesms projecs
ur drmolision aoless the owner nr oP<nlor Aar obmined written approval from 00.CM. A wdllen applicnsion foe a
demolition shall Indade a ttrGOosioo that shore is no known asbesmo-comaininp melerlrl rxmaining In the area of We
ilruClure. '~ / 99
Yt~o eC( Site Address' ~-.,( / ~ N~~R~1 /7 Ulm ~ !~
} ~ Count}': 1'4f's L:
~.
City. C 1 .`Slate'- L".I )~ 7ip'. ~ i~ ~_
Starting Date-.
_ Completion Date:
"(Them is a 10 wndung day advaarq omilcntion pniod Rem receipt o(FcamhFPhcetion)
Prapert}~Owner_ .l^ / iC Telephone ~5~+-7575 Fux
Mailing Address'. IC ~"'' yy(~~C.e }e¢3 G~ SL'
~ _
Demolition Centrector: 73~ ~i(~~[f~ f(C. $lala License r':~Hl~(,~ G.T e`-~jl_G=
Mailing Address: L'_ Gj (,( S'7 __
Lily: ~ y~lo~ $l 'e'. ~ iH Z' a~y_'T
Contest person ~~ Jig _, _Telephone )(17 ~j f 3~ ~7 Fa+. !~ ~-- GG JS
YE.S NCB
u_. Denminiat by 1t'ruckiuF el Disnlandinc' (F 75.00 ;eel clred[ r_nonrefundable
Trlining fire Dumol'aien'! (frye=_, allzch Gru dep}-Imem rcgoesl (ol lrainir_e tool
Aenovation, Alteration, R.modeling. Pdaintenance, of other Consn'urlion?
_=. Asbestos lomsd nr su spectcd`
"An ORGA "Nonce el Inlue m Nem~.e m Encrysulan A.be=mr" to,m on. app~cVao,o fee rma b: :oemmd rn ~ .c _ mna.
.an vat wmk Arl+eum mmo~d profs[ s nrun-~V d~m,.bq~ .: be pnfonv:J by a Coeb:d A•f<.'~ov l [+~nv:a ,nn JI ~bsl'IC ,
pnmmielp' Liable aebcsms muse Fe mm.a.ed uefom up demulinen he P'ns seCi ~o OP.CAA fiegulauoe I ,\riulc li Ive cJ~~w~.~
mgdrtann'.ts Thal n,q' apply
~bess us Svra~e}' Completed bl
AHE1L4 Certified Inspector- ~~ _
Ccrtincatibn r?
Th:s appvmcd prmail muss Entlme RS Cerificumu n`Ihe Asbestos Sowermwl
be Bailable at the iob site Proceaeing Fev occo'nl!am'Ihis h+rtr.
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