07-0167 Permit Pkg 041207City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Applicant:
Name: Mr. Dougs
Address: 210 103rd Ave. SE
Property Information:
Site Address: 210 103rd Ave. SE
Assessor Parcel No. 22730110202
Contractor Information:
Name: Airtech
Address: 2505 Brentwood P1. SE
Contractor License No: AIREW1010KO
Project Information:
Project: Mr. Dougs
Description of Work: Install New Hood System
Sq. Ft. per floor: (1st) 0 (2nd) 0
Heat Type (Electric, Gas, Other):
Permit No: M-07-0167-YL
Issue Date: Not Issued
(Work must be started within 180 days)
Receipt No: 47992
City: Yelm
Phone: 458-2359
State: WA Zip 98597
Subdivision:
Contact:
City: Lacey
Expires: 05/21/07141
(3rd) 0 Garage 0
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate
Mechanical Permit 29.50 0.00 _ 0.00 0.0006
TOTAL FEES: $29.50
Lot:
Phone: 459-3286
State: WA Zip: 98503
Business License:
Basement 0
No. Units Unit Desc
0.0000
c~~
Applicant's Affadavit:
OFFICIAL USI
I certify that I have read and examined the i nformation contained within the application and know the same
to be true and co ct I also certify th roposed structure is in conformity with all applicable City of # Sets of Prints:
Yelm regulatio incl ding those erni ing and land subdivision, and in addition, all covenants,
easements a d rests lions of ord. a y' g as a contractor, I futher certify that I am currently
registered i the St a of W ing Final Inspection:
Signature Date ~~-O~ Date:
Firm ,~ I 1/n
By:
~;~~ ~"°°ti °'~ CITY OF
a
YEL1~1
Yeln?, WA 98GU/
YBLM 360-458-3214
RECEIVED **`*TWENTY NINE DOLLARS & 50 CENTS
REI~ENEU FFi~M DATE= REC. Na.
MR. DOUGS 04/12/07 47992
210 103RD AVE SE
YELM WA 98597 BUDGETARY
`- ~~~2
RECEIPT No. ~' ~ ::
AMOUNT REF.NO,
29.50 CHECK 7642
_ GRETCHEN
29.50
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CITY OF YELM
COM~~JMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address:~!~~- L' I ~ G• Parcel #: o •2 ~ ~ ~Co2C~
Zoning; urrent Use: ~Y Proposed Use: ~ K
U New Construction ~Re-Model / Re-Roof /Tenant Improvement
U Plumbing u Mechanical U Fire P vent/Supp~ress/Alarm u Oth r
Project Description/Scope of Work: ~~ L ~~~ .y .
Project Value: 'S~; CCC~
Building Area (sq. ft) Parking Garage 1~' FloorSc~EL 2nd Floor 3'~ Floor
GENERAL CONTRACTOR ~~~ TELEPHONE
ADDRESS ~ EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE_CITY LICENSE #
Copy of Clty Mklgatlon documentation (TFC).
I hereby certify that the above Information Is correct and that tha construction on, and the occupancy and tha use of the
above described property will be In accordance wkh the laws, rules and regulations of the State of Washington and the
City of Yelm.
L
Applicant's Signatfire- - Date
Owner I Con actor l,Ownen's Agent /Contractor's Agent /Tenant (Please circle one.)
All permits are non-transferable and will expire if work authorized by such permit is not begun
within 180 days of issuance, or if work is suspended or abandoned for a period of 180 days
]05 Yelm Auenue Weat (360) 458-3&35
PO Bor 479 (360) 458-3144 FAX
Yelm, WA 98597 www.ci.,yelm.wa.ua
Building Height
1
Are there any environmentally sensitive areas located on the parcel? ~f. If yes, a
completed environmental checklist must accompany permit application.
COUNTY COMMISSIONERS
Cathy Wulfe
District Onr
Diane Oberquell
District Two
Robert N. Macle~xl
District Three
THURSTON COUNTY PUBLIC HEALTH AND
s~~~E ~~5z ~ SOCIAL SERVICES DEPARTMENT
Sherri McDonald, RN, MPA,
February 15, 2007 Director
Diana T. Yu, MD, MSPH
Health Officer
Mr. Doug's
Attn: Doug Cameron
P.O. Box 698
'reim, WA 98597
Regarding: Plan Review -New Kitchen for existing Mr. Doug's facility
Dear Mr. Cameron:
I have completed my review of the plans and information that were submitted for the
construction of a new Izitchen for Mr. Doug's restaurant, which is located at 107 Nisqually Plaza
in Yelm, Washington. The plans are acts teed with the following conditions:
1. All building, planning, fire and electrical code requirements must be completed prior to
calling for apre-opening inspection. Please call (360.754.3355 ext. 7390) at least 7 days
prior to your planned re-opening to schedule apre-opening inspection.
2. Your proposal to use the last compartment of the three compartment sinkts for ahand-
wash sinlz is acceptable on a performance basis. Should future inspections/complaints/etc.
reveal a lacks of hand washing, one or more additional hand wash sinlz(s) will need to be
installed in the grill area/salad prep area.
3. Your request to eliminate the mop sinlz from your establishment is also accepted on a
performance basis. My understanding is that you will use a vacuum to collect the dirty
water from the the areas of your lzitchen and empty the vacuum into the scrap
accumulator of your dishwasher. Should future inspections/complaintsletc. reveal
improper/inappropriate dumping of wastewater, immediate installation of a standard
mop sinks might be required.
4. Most of the menu that was submitted for review consists of cookz and serve food. The only
food that was described as being cooled and re-heated was baked potatoes that were
cooled over night and re-heated as home fries for breakzfast the next day. When cooling
bared potatoes, they must be uncovered (no foil wrapping) and in a single layer
(maximum 2" diameter). The waltz-in must have an air temperature of 41°F or colder.
5. All equipment should be NSF approved or its equivalent.
Environmental Health Division: 2000 Lakeridge Drive SW, Olympia, Washington 98502-6045 (360) 786-5490
Fax (.360) 754-4462 • TDD (360) 754-2933
www.co. thu rston.wa. us/health
Recycled Pater
Mr. Doug's
February 15, 2007
Page 2
6. All floor, wall, ceiling, and shelf surfaces must be smooth, durable, nonabsorbent and
cleanable. All exposed, unfinished wood in food preparation and storage areas must be
properly sealed. All openings around utilities and conduit passing through walls, floors,
and ceilings must be sealed. ,.
7. Area rugs with absorbent surfaces shall not be used in dishwashing, food preparation, food
storage, and/or food dispensing areas. The wall/floor juncture must be properly coved.
8. All lights in food preparation, service, and storage areas must have proper shields or
guards.
9. Indirect drains must be provided for beverage dispensers, produce sinks, food preparation
sinlzs, ice machines, walkr-ins, condensate from refrigeration units and any unit used to
dispense food/beverages.
10. When you use the first compartment of the three-compartment sinkr to wash produce or
thaw frozen meat under running water, your staff must clean and sanitize the siniz (and
colander) before and after each use. A colander will be used to Fieep food from "soal2ing"
in standing water.
11. All hand-wash sinks must be provided with soap and paper towels (and dispensers). Hot
and cold water, under pressure, must be available at all times at hand-wash sinks and
three-compartment sinks. A clearly visible sign or poster that notifies food workers to wash
their hands must be posted at each hand-wash sink.
12. Restrooms must be mechanically ventilated to the outside. Restroom doors must be self-
closing and cannot be propped open. The women's restroom must have a covered waste
receptacle.
13. All refrigeration units must have visible workring thermometers.
14. A food probe thermometer, with a minimum range of O°F to 220°F, must be obtained
and used to check food temperatures.
15. All workers in food service establishments must have a valid food and beverage service
worker's permit within fourteen days of employment. Individuals may work for up to
fourteen calendar days without a food and beverage service worker's permit provided
that they receive information or training regarding safe food handling practices from the
employer prior to commencement of employment. Documentation that the information
or training has been provided to the individual must be kept on file by the employer.
16. Apre-opening inspection must be scheduled and conducted prior to opening for business.
After the pre-opening, you will be billed for the plan review, pre-opening inspection, and
Operating Permit. Fees must be paid as specified in the billing.
t7. Any expansion of menu, addition or change of equipment, or remodel of the establishment
requires review by this Department.
Mr. Doug's
February 15, 2007
Page 3
t8. This letter and the establishment file reflect items discussed during plan review. You will be
responsible for meeting all requirements of Article II, Rules and Regulations of the Thurston
County Board of Health Governing Food Service. If you do not have a copy of this
information, please contact our office. All other conditions previously established by this
office regarding the operation of this food service facility shall remain in effect.
19. Our records indicate that your establishment is in the following billing category with the
corresponding square footage for each category. If our records are incorrect, please let us
krnow.
Category Square footage
Food Processor 1900 Square Feet
If you have questions or would like to schedule apre-opening inspection, I can be reached at
(360) 754-3355 extension 7390.
Sincerely,
~~
Kay L. Massong R.S.
Environmental Health Specialist
cc: Gary Carlson, City of Yelm Building Department
COUNTY COMMISSIONERS
~r ,,?~ Cathy Wolfe
/~ CEO ii~r District One
~. , __ _~ Diane Oberquell
-- ~~~~ :~Fe ~, ,
-~ (U(~S District Two
Robert N. Macleod
District Three
THURSTON COUNTY PUBLIC HEALTH AND
SINCE 1852 SOCIAL SERVICES DEPARTMENT
December 27, 2006
Mr. Doug's
Attn: Doug Cameron
P.O. Box 698
Yelm, WA 98597
Sherri McDonald, RN, MPA,
Director
Diana T. Yu, MD, MSPH
Health Officer
Regarding: Plan Review of Mr. Doug's -New Kitchen for existing facility
Dear Mr. Cameron:
I am continuing my review of the plans that were submitted for the construction of a
new kitchen for Mr. Doug's restaurant, which is located at 107 Nisqually Plaza in
Yelm, Washington. I cannot approve the plans as submitted because some items
are un-clear or missing:
1. Your proposal for the hand-wash sink location is acceptable on a performance
basis Should future inspections/complaints/etc. reveal a lack of hand washing,
an additional hand wash sink will need to be installed in the grill area.
2. Your request to eliminate the mop sink from your establishment did not address
the disposal of the wastewater that will be picked up by the vacuum.
My review will continue when more information is received. If you have questions, I
can be reached at (360) 754-3355 extension 7390.
Sincer ly,
a~r~
Kay L. Massong, R.S. ~/
Environmental Health Specialist
cc: Gary Carlson, City of Yelm Building Department
Environmental Health Division: 2000 Lakeridge Drive SW, Olympia, Washington 98502-6045 (360) 786-5490
Fax (360) 754-4462 TDD (360) 754-2913
www.co.thurston.wa.us/health
Itccy.lr~i I',q ci
COUNTY COMMISSIONERS
r Cathy Wolfe
~~ District One
' ` C ~ / VLF Diane Oberquell
,l}; ~ ~+` _ ,YU~~ ~ C Q District Two
_ -„,~`~~ !,_; ,4 ?0p6 Robert N. Macleod
r'~ - ---- -- '~.~
District Three
THURSTON COUNTY PUBLIC HEALTH AND
S~N~ «s~ ~ SOCIAL SERVICES DEPARTMENT
November 7, 2006
Sherri McDonald, RN, MPA,
Director
Diana T. Yu, MD, MSPH
Mr. Doug's Health Officer
Attn: Doug Cameron
P.O. Box 698
Velm, WA 98597
Regarding: Plan Review -New Kitchen for existing facility
Dear Mr. Cameron:
I have started my review of the plans that were submitted for the construction of a new Izitchen for Mr.
Doug's restaurant, which is located at t07 Nisqually Plaza in Yelm, Washington. I cannot approve the
plans as submitted because some items are un-clear or missing:
1. We have not reviewed your menu since 1998. I have enclosed a copy of your 1998 menu. Please
review it and make changes as needed to update the information.
2. While you review the menu, please identify any items that will be coolzed, cooled, and re-heated in
your restaurant. If any of these items are Potentially Hazardous Foods (PHF),1 will need a flow chart
for their preparation and service.
3. Please submit a copy of the specification sheet for all new equipment that is proposed and a list of the
mane and model number of all the used or existing equipment.
4. After further review of the plans that were submitted, it appears that the three-compartment sinks
will be too far away from the food preparation area (grill and prep table). A hand wash sinks can go
on the same wall as the dishwasher, but it will need to be located where the worker can reach it
without leaving the food preparation area. The proposed three compartment sink is around the
corner and down the wall from the maize table and grill.
5. A waiver from the code will be required to use one of the three compartments of the three-
compartment sinkz as a food preparation sinix. it a waiver is granted, this sinkz will not be used for
anything except washing produce and it will require an indirect drain. I have enclosed a waiver
request form.
If you have questions, I can be reached at (360) 754-3355 extension 7390.
Sincerely,
_~ < ~ ~
s~
~,
Kay LJ Massong, R.S. ./
Environmental Health Specialist
Enclosures
CC: Gary Carlson, City of Velm Building Department
Environmental Health Division: 2000 I_akerid~e Drive SW, Olympia, Washin~ma~ 9~`~502-6045 (360) 7ti(, ~~~~0
Fax (360) 754-4462 TDD (360) 754-2933
www.co. thurst~~n.wa.us/health
ti~,,,~: ird r.,~,.,~
nov os as o2:2sP p.1
° E
W E S T ~ ~~~
. PROPOSAL /,a,~~,~ VGA g85o~
Install new 10ft. backshelf
Includes:
• New stainless steel backshelf ~ ~y f : ~~~~ ~~
• New exhaust fan --
• Curb for exhaust
• Filters, grease cup, pre-wired light
• Fire Wrap
• Installation
Excludes:
• Fire Suppression System
• Back splash
• Permits
• Electrical
• Electrical shunt trip
• Gas line
Total Bid Cost:
Six Thousand Seven Hundred Dollars no Cents
$6,7x4.00 excludes tax
D.....,.. d.,4- C..s, sa7.1e
Percent
Due Date
Due Amount Due
50°~6 Upon Acceptance of bid $3,352.00 lus tax
50~ Due u n completeion $3,352.00 ius tax
Every payment not received by the 15~' of the month wits assess a late payment charge of $25.00 per
late payment.
~~~1C
2505 Brentwood P'Iace S.E. • Lacey, WA 98503 • 360.459.3286 • Fax 360.456.5792
AirTech West hereby submits specifications and estimates for consideration:
Kessler Brothers Construction
6625 "I'acotna Mall Blvd
Tacoma, tiVA 98409
' BiY To
MR UOUCrS
FA,Y: 360-458-? 14l
P.O. Number I Terms Rep Ship , Via
varhal ?J8l200?
t
Quantity Item Code
_ p~«1
ption
MR. DOUGS
S!S Fabrication CANOPY HOOD INSULATED PADS
HALL PADS A:VD CIILITG PADS
13' LONG X 9' HIGH; 13' X 4'
INCLUDES CORNER GUARDS
Install & Deliver I Dh'1.IVERY Ah'D IlYSl_AI,LA'1TON
' IIJSTALLATIO~I W1TI-I NO CHARGE FOR
I TRAVEL
Invoice
Date Invoice it !
Ship To
V1R DOUC'iS
KA.Y: 360-458- i 14 J i
1
1
I
F.O.B. ~ Project
Price Each Amount
2,080.00 2,030.00
1,360.UO 1,3GG.U0
Total s3,aao.uo j
l'd rbSltr4b£5Z N3lSS~~i d9£~£0 LO £L qe-i
Wed Mar 1 12:43:73 2006 360 754-1881 P. 1
AMERISAFE, INC
3430 PACIFIC AVE SE A-6 #402
OL'Y~IPIA, WA 98501
'.ADO-o~"7jJ~
Name /Address
Box 698
WA 98597
Estimate
Date Estimate No.
03/01/06 4
Project
Item Description ay Rate Total
13334 FE KP375 CYL ASY USA 272.16 272.167
16085 BKT WALL MOUNT ASY KP375 63.00 63.007
11977 MRM ACTUATOR ASY RS 145.13 145.137
12853 ENCL ASY MRM RD RS 77.25 77.257
12508 DETECTOR ASY 4 10.50 42.007
12329 Fusible Links 4 9.75 39.007
12891 LINK TEST 2.50 2.507
12856 CYL NIT 10 CU IN ;ASY RFSS 104.50 104.507
10173 VENT CHECK 36.75 36.757
12309 Corner Pulleys 20 5.865 117.307
12553 Cable 1/16" 95.70 95.707
11993 PULL STATION ASY KP 41.58 41.587
12276 3/8 Seat 10.50 10.507
12512 EMT SEAL 16.95 16.957
13729 Switch 17.40 17.407
11982 NOZ APPL/PLN 1X38 W/CAP 17.40 17.407
16416 NOZ DUCTY6 ]XD W/CAP KP 17.40 17.407
14178 Nozzles 3 26.94 80.827
12792 VLV ASY GAS MECH 1 1/4 KP 168.75 168.757
PIPE PIPE Tees Elbows Pipe nipples ect. 190.00 190.007
Labor Labor Hours for System Install 7 75.00 525.007
PERMITS Permit for Job city of Yelm 205.00 205.007
Labor Labor Hours for System Install Less tabor -7 75.00 -525.007
for system for used equipment
Sates Tax 8.40% 147.93
Total $1,y09.0Z
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General/Specialty Contractor
A business registered as a construction contractor with L&I to 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 AIRTEWIOtOKO
Licensee Name AIRTECH WEST INC
Licensee Type CONSTRUCTION CONTRACTOR
UBI 601922728 Verify Workers Comp Premium
Status
Ind. Ins. Account
Id
Business Type CORPORATION
Address 1 2505 BRENTWOOD PL SE
Address 2
City LACEY
County THURSTON
State WA
Zip 98503
Phone 3604918736
Status ACTIVE
Specialty 1 GENERAL
Specialty 2 UNUSED
Effective Date 5/20/1999
Expiration Date 5/21/2007
Suspend Date
Separation Date
Parent Company
Previous License AIRTEW'055LT
Next License
Associated
License
Business Owner Information
Name Role Effective Date Expiration Date
YATES,RONALD P 01/01/1980
YATES, ROMA 01 /01 / 1980
Bond Information
Bond Bond
Company Account Effective Expiration Cancel Impaired Bond Received
Bond Name Number Date Date Date Date Amount Date
Until
https://fortress.wa.gov/lni/bbip/Detail.aspx?License=A1 RT'EWI01 OKO 4/10/2007
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#2 CBIC 569995 03/15/2002 Cancelled $12,000.00 03/05/2002
N1 CBIC 589995 03/15/1999 03/15/2002 $6,000.00
Savings Information
No Matching Information
Insurance Information
Company Effective Expiration Cancel Impaired Received
Insurance Name Policy Number Date Date Date Date Amount Date
OHIO CAS
#5 INS CO BK053087236 06/01/2005 06/01/2007 $1,000,000.00 05/15/2006
US
FIDELITY &
GUARANTEE Until
#4 B K01217901 06/01/2002 Cancelled $2,000,000.00 08/20/2002
FIDELITY &
DEPOSIT CO Until
#3 OF MD BK00950321 06/01/2002 Cancelled $1,000,000.00 05/06/2002
FIDELITY l3
GUARANTY Until
#2 INS CO BK00876288 06/01/2001 Cancelled 06/12/2001
Until
#1 USFiiG BF500000137444 06/01/1998 Cancelled
Summons /Complaints Information
Tax
Summons / Cause Warrant Complaint Complaint Judgement Judgement Payment Payment Dismissal Paid
Complaint Number Id Plaintiff County Date Amount Date Amount Date Amount Date By
SIDANI
#1 002141904 INC KING 05/22/2000 $14,200.00 $0.00 $0.00
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~(/ ~ About L81 ~ Find a job at L81 ~ Information en espatiol i Site Feedback ~ 1-800-547-8367 . weshie On
' ~~ =Washington Stare Dept., of Labor and InUusl ri(?S. Use nl this stte Is subject to the taws of the stage of Washmgto ~ ~ ~
~- °~ Auess Agreement I P~ivary and scY:urlty statement ( Intended use:exic:u~at content policy ~ Staff only IMk .__.~.:.;;m.
https://fortress.wa.gov/Ini/bbip/Detail.aspx`?License=AIRTF WIO 1 OKO 4/ 10/2007