20050598 Permit Pkg 061406~Oti TAP City of Yelm
Community Development Department
d
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Applicant:
Name: B&H Builders
Address: P.O. Box 1959 City: Yelm
Property Information:
Site Address: 211 Yelm Ave. West
Assessor Parcel No. 85800300400 Subdivision:
Permit No: BLD-05-0598-YL
Issue Date: 06/14/2006
(Wor k must be started within 180 days)
Receipt No: 42391
Phone: 458-3277
State: WA Zip 98597
Lot:
Contractor Information:
Name: BbH Builders Contact: Hunt, David Phone: 458-3277
Address: P.O. Box 1959 City: Yelm State: WA Zip: 98597
Contractor License No: BHBUII'093C6 Expires: 07/01/07182 Business License:
Project Information:
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: $518.35
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.
~_
n
Signatu~ ~ l~ Date ~% //
Firm ~ / / ~r ~ i /~~
Date:
of Prints:
CITY OF
YELM
P.O. Box 479
Yelm, WA 98597
360-458-8403
RECEIVED ****FIVE HUNDRED EIGHTEEN DOLLARS & 35 CENTS
RECEIVED FROM DATE REC. NO.
B&H BUILDERS 06/14/06 42391
PO BO% 1959
YELH. i1A 98597 BUDGETARY
BLD-05-0598-YL
SITE: 211 YELH AVE W
RECEIPT No. 4 2 3 91
AMOUNT REF. NO.
518.35 CHECK 7900
DIANA
Receivcd
MAY 1 7 2006
CITY OF YELM
COMMF.RCWL BUILDING PERMR APPLICATION FORM
Project Addrssa:~ (~ ~~-e~fr"~ ~~ JrZ-- Parcel #: ~5 `SOD SOU ~~
Zoning; Current UsO: Proposed Use:
fl New ConsWctiort ,~Re-Model / Ro-Roof /Tenant Improvement
^ Plumbing 0 Mecheudcal ^ Fire Prevent/Suppress/Alarm ^ Other
Project Description/ScopeofWork: l+'~'1~!•:~~~ t~l,~1H5 i~~~ /3rl~~c-7c.~~R~.'-~~- (,u~L°.-~~'~ R~~•`'/° N~~a c
Project value: ~ '.J. ~'~'~~% Li2'
Building Area (sq. ft) Parking Garage id Floor/ D ,1 Zn0 Floor 3f° Floor
Building Height ~ ~ /
Are there any entironmentally aensttive areas located on the parcel? ~~~~ !f yes, a
completed environmental chsckUsf must accompany permit applk~tion.
^~Copy of city Miagaslor+ dowm~nMion (TFC).
usa
/~
Applicant's Signature Date
Owner /Contractor /Owner's Agent / Contsactor's Agent /Tenant (Please circle one.)
All permits are non-transferable and will expire if work authoriYed by such permit is not
begun within 180 days of iasuance~ or if work is suspended or abandoned for a period of
180 days
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b00/Z00'd LOOisd bbl£ 8Sb 09£ A30 WWOJ-W131~ d0 AlIJ 6060 £OOZ-OI-N(lf
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General/Specialty Contractor
A business registered as a construction contractor with LEtI 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 BHBUII*093C6
Licensee Name B ii H BUILDERS INC
Licensee Type CONSTRUCTION CONTRACTOR
UBI 601270968 Verify Workers Comp~_remium
Status
' Ind. Ins. Accou ~ 80063600
Business Type CORPORATION
Address 1 PO BOX 1959
Address 2
City YELM
County THURSTON
State WA
Zip 98597
Phone 3604583277
Status ACTIVE
Specialty 1 GENERAL
Specialty 2 UNUSED
Effective Date 2/26/1991
Expiration Date 7/1 /2007
Suspend Date
Separation Date ~
Parent Company
Previous License WESTCC*194PZ
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Associated
License
https://fortress.wa.gov/Ini/bbip/Detail.aspx?License=BHBUII * 093 C6 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
Bond Bond
Company Account Effective Expiration Cancel Impaired Bond Received
Bond Name Number Date Date Date Date Amount Date
AMERICAN
STATES Until
#6 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 li
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 Date
NATIONAL
FIRE &
#12 MARINEINC 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 Et
MARINE INS
#10 CO 72LPE690245 07/15/2003 07/15/2004 $1,000,000.00 07/16/
NATIONAL
FIRE It
#9 MARINE 72LP148217 07/15/2002 07/15/2003 $1,000,000.00 08/16/
TRAVELERS Until
#8 INS CO 1680254L1806 07/01/1998 Cancelled
https://fortress.wa.gov/Ini/bbip/Detail.aspx?License=BHBUII*093C6 6/6/2006
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AETNA CAS
8 SURETY
#7 CO 081MP0026043829 07/01/1997 07/01/1998
AETNA
CASUALTY &
#6 SURETY CO MP0025567022 07/01/1996 07/01/1997
FARMINGTON
CASUALTY
#5 CO MP24907884 07/01/1995 07/01/1996
FARMINGTON
#4 CASUALTY 081MP0024202914 07/01/1994 07/01/1995
AETNA
#3 CASUALTY 081MP0022533820TWF 07/01/1992 07/01/1994
AETNA
#2 CASUALTY 081MP0021467705TWF 07/01/1991 07/01/1992
AETNA
#1 CASUALTY 081MP20344742 07/01/1990 07/01/1991
Summons /Complaints Information
No Matching Information
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Washington State Dept. of Labor and Industries. Use of this site is subject to the laws of the f ~-- ~-wV8Shi0pt011
state of Washington.
Access Agreement I Privacy and security statement I Intended use/external content policy I 'visit a[cc ss,. w,a.gov
Staff only link
https://fortress.wa.gov/lni/bbip/Detail.aspx?License=B HBUII * 093 C6 6/6/2006
PERMIT#
Fax. (360) 4g1-6308 ww,'w.ORCAA org
Notification of Demolition Pe~-n~it
~ vtv c
~ ~ ~
o~ !-~ ~
~.\~ORCAA ~~
Olympic Region Clean Air Agency
2940-8 Limited Lane NW
Olympia, WA 98502
(360) 586-1044 ar 1-800-422-5623
NOT APPROVED
FOR COMPLIANCE WITH
ORCAA REGULATION 1
It is unlawful for any pv!lon to couSe or allow the demoliliun (or major renovotimt) of qny elntclure unless all asbeetos-
contgining materlglt have been ranoved from the area to be demolished. Work s1to11 not comrtunce on an asbestos project
or demolition anlcss the owner nr operator has obtained wrillen »ppro~•al from ORCAA. A Nrlllen gpplic»lion for a
demolition shall include a cerUfieativn that there is no known asbestos-conhining materlH rcmAioinK In the area of Jhe
structure. _
Pt•oject Stte Address. _ ~~ ~ / ~~t~•1 l ~ Ui:- Counl_~ 1 `~ ~ % fit' ~~
c,ry -, ~ Iti I c r ~
y _ _ _ ____ State:_ ~~~ ~ 7_t ~ ->
Startrng Date. _ Completion Date.
'(There is a 10 wortung day adva;rce,,,orificntton peteod from rtcnpl of permit apphcationl
Preperh~ Uw~net.~ ,."t'' / '' ~ ~ Telephc,nca l ~ 7 S ' ~ Fnx
hlailtng Address -t- ',, ) ,' ~ ku~ l~ ~-
_~.
City ~ ~ L` ~-' - ,,J--~- ~ C
State: ( ~ -_~.-_._Z•ip. ~. ~,~ ,
/ ~_
Demolition Contractor ~ .3 / ~~~~~'~ 1 r'~ _ Slaty license # ~~ D (~ _L..T [`~~ C. C,~
A4aJlJr.~ Address. l ~`~
Cc,nlacl Person k1~ ._ ~j~ ~ __ _Telephor;e•~~(~C~' y~ ~' _~,~ 71 Fax. 1/`~ ~ ~ G~ 75
~^ I~emolltlon h~ Wrcc.kuig el Utsntantling'' ~9._S,pl ;~e! rh-:li ~ _notu efundable
Trtiulne Fire D~m~~litien elf yes, at;e.h (ire deb s;tmcnt toques' frn train~ne tl;e)
Rcno~atlen, Alleratlon, EZ~Illodelili~ T:13tr.tenance, o~ other ~'~r:75rru~ lion?
r;
~` Asbestos lout-d nr suspected'
}Ah OfiC.iA "3VnheP f•I Intlnl lu ktmnat M Eneay:ulyti 4.be~tnq" Jour aqA a~ptrpr,itr (tc moot b: sutmtlted ~n_r .c r:. o-tuto-
atruval work Ash.itns rcmnirl ~ro~cct5 unolv~~; demrhhen Inu': be preformeJ >,y u Contficd A~t•e~t~•. ('; ntr-+e,rr vnrl ,ill 'r alas o,
potcut.all)' 8i,i61c rabcstvs must he rcmm•cd fefote am Jtmclruer. hems Aefcr ro URCl~n P.Pgttlanut ! ~rl,ilc la fir a~dr,unr'
rcq^truncnts that ma} rpplti
_ ~bestus Sur~e~~ Completed b~
AHZ/IL4 Certified inspector
--~~ ._
CcrtifjcatlUtt #
7hl^ alr!,rn:'cd prrnul must Enclocc ~2S (-rmfiran,~tt n` t!,r q cl est~~~ tiu~- Fr n...>~
bP a'~arlablt at the toy site Prucet;6luJ; For ac:ninl~am tLls f~~;tr.
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