08-0004 Permit fee sheet & AppCity of Yelm Permit Fees Schedule
Community Development Department Permit No: BLD -08- 0004 -YL
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: Smith Fire Systems
Phone:
253 - 926 -1880
Address: 1106 54th Ave. SE
City:
Tacoma
State:
WA Zip 98424
Project Information:
Project: Creek St. Plaza
Description of Work: Sprinkler Permit for Building A
Site Address: 1304 Yelm Ave. East
Assessor Parcel No.
22730140100
Fees:
Item Acct Code
Item Fee
Base Amt Unit Fee
Unit Rate
No. Units Unit Desc
---------- --- -------- - -- --- -------- - - ----
Building Permit - Other 032 001 - 322 -10 -00
----- - - - ---
451.85
----- - - - - -- --- -- - -- - --
0.00 0.00
-- -- - - -- - --
0.0000
----- -- - - -- -- ----- - - - - --
0.0000 $1,000
Building Plan Review 100 001 - 345 -83 -00
293.70
0.00 0.00
0.0000
0.0000
TOTAL FEES:
$745.55
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: 130� WeK i%✓e Parcel #:
Zoning; Current Use: Proposed Use:
❑ New Construction ❑ Re -Model / Re -Roof / Tenant Improvement
❑ Plumbing ❑ Mechanical )( Fire Prevent/Suppress /Alarm ❑ Other
Project Description /Scope of Work: r /1'(, SOri✓ le r
Project Value:
Building Area (sq. ft) Parking Garage 1 st Floor 2 "d Floor 3`d Floor
Building Height
Are there any environmentally sensitive areas located on the parcel? _
completed environmental checklist must accompany permit application.
BUILDING OWNER/ TENANT NAME: kec oer+ U ns1f-( -L C-tio c-I
ADDRESS 20,20 EMAIL
CITY 8ubuTn STATE_&2d_ZIP9JD0_ TELEPHONE
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
If yes, a
GENERAL CONTRACTOR di, Fre— tefi -6 TELEPHONE %
ADDRESS 11666 z E 1 EMAIL
CITY %CzCOI)')CZ STATE _ZIP -/2/ FAX 5_ 02tv-235C
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 City Mitigation documentation (TFC).
1 hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the
above described property will be in accordance with the laws, rules and regulations of the State of Washington and the
City of Yelm.
n� ///d7 O
Applicant's ignature Date
Owner /r4Cbntractoy Owner'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
105 Yelm Avenue West (360) 458 -3835
PO Box 479 (360) 458 -3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us
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General /Specialty Contractor
A business registered as a construction contractor with LEI 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
SMITHFS1360T
Licensee Name
SMITH FIRE SYSTEMS INC
Licensee Type
CONSTRUCTION CONTRACTOR
UBI
601046860 Verify Workers Comp Premium
Status
Ind. Ins. Account
Id
53254700
Business Type
CORPORATION
Address 1
1106 54TH AVE E
Address 2
City
TACOMA
County
PIERCE
State
WA
Zip
98424
Phone
2539261880
Status
ACTIVE
Specialty 1
FIRE PROTECT SYSTEM
Specialty 2
UNUSED
Effective Date
9/30/1987
Expiration Date
11/2/2008
Suspend Date
Separation Date
Parent Company
Previous License
Next License
SMITHFS947LP
Associated
License
Business Owner Information
Name
Role
Effective Date
Expiration Date
SMITH, MARK B
01/01/1980
SMITH, SERENA L
01/01/1980
Bond Information
Bond I Bond I I I `
Company Account Effective Expiration Cancel Impaired I Bond I Received
https: // fortress. wa. gov /lni /bbip /Detail.aspx ?License = SMITHFS 1360T 1/4/2008
Look Up a Contractor, Electrician or Plumber License Detail
Bond
Name
Number
Date
Date
Date
Date
Amount
Date
Insurance
INS CO
Policy Number
Date
Date
Date
Date
Amount
Date
OF THE
Until
#3
WEST
1135292
09/27/2001
Cancelled
$6,000.00
11 /01 /2001
#20
INS CO
51GL000098071
11/02/2007
11/02/2008
$1,000,000.00
11/01/2007
OF THE
#2
WEST
1135292
09/25/1989
09/27/2001
$4,000.00
#1
CBIC
655126
09/25/1987
09/25/1989
$4,000.00
11/01/2006
Savings Information
No Matching Information
Insurance Information
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https:H fortress. wa. gov /lni /bbip /Detaii.aspx ?License = SMITHFS 1360T 1/4/2008
Effective
Expiration
Cancel
Impaired
Received
Insurance
Company Name
Policy Number
Date
Date
Date
Date
Amount
Date
EVEREST
INDEMNITY INS
#20
CO
51GL000098071
11/02/2007
11/02/2008
$1,000,000.00
11/01/2007
EVEREST
INDEMNITY INS
#19
CO
51GL000098061
11/02/2006
11/02/2007
$1,000,000.00
11/01/2006
EVEREST
INDEMNITY INS
51GL0000980
#18
CO
51
11/02/2004
11/02/2006
$1,000,000.00
10/31/2005
EVEREST
INDEMNITY INS
51GL000098-
#17
CO
032
11/02/2003
11/02/2004
$1,000,000.00
10/31/2003
EVEREST
INDEMNITY INS
#16
CO
51GL000098031
01/02/2003
11/02/2003
$1,000,000.00
01/02/2003
UNITED
NATIONAL INS
#15
CO
L7155683
11/02/2001
11/02/2003
$1,000,000.00
10/30/2001'
UNITED
NATIONAL INS
#14
CO
L7155683
11/02/2001
11/02/2002
10/30/2001
FIRE ft
CASUALTY CO
#13
OF CT
PSP10061100
11/02/2000
11/02/2001
MASSACHUSETTS
#12
BAYINS CO
ZDZ531065002
11/02/1999
11/02/2000
MASSACHUSETTS
#11
BAY INS CO
ZDZ531065001
11/02/1998
11/02/1999
MASSACHUSETTS
#10
BAY INS CO
ZDZ531065000
11/02/1997
11/02/1998
NORTH
AMERICAN
#9
SPECIALTY INS
52C000015300
11/02/1996
11/02/1997
SCOTTSDALE INS
#8
CO
CLS0338541
11/02/1995
11/02/1996
SCOTTSDALE INS
#7
CO
CLS0254530
11/02/1994
11/02/1995
SCOTTSDALE INS
#6
CO
CLS102786
11/02/1993
11/02/1994
ROYAL INS CO
#5
OF AMERICA
PSP199866
11/02/1991
11/02/1993
ROYAL INS CO
#4
AMERICA
PSP066719
11/02/1989
11/02/1992
Page 2 of 3
https:H fortress. wa. gov /lni /bbip /Detaii.aspx ?License = SMITHFS 1360T 1/4/2008
Look Up a Contractor, Electrician or Plumber License Detail
#3
ROYAL INS CO
OF AMERICA
PSP066719
11/02/1988
11/02/1989
ROYAL INS CO
#2
OF AMERICA
PSP0667190000
09/25/1988
09/25/1989
AETNA
CASUALTY Et
#1
SURETY
81CO243354
09/25/1987
09/25/1988
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https://fortress.wa.gov/lni/bbip/Detail.aspx?License=SMITHFS1360T 1/4/2008