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20100070 New Years FW Permit 11222010 November 22, 2010 Attention Gary. City of Yelm PU Box 479 Yelm WA 98597 RE: FIREWORKS PERMIT -1.4G CONSUMER FIREWORKS Dear Gary, Please find enclosed an updated packet submitted to you for the purpose of a Class "C" Fireworks trailer for the 2010-selling period of December 29`h thru January 1, 2011 The information provided in this packet is for a fireworks trailer located at: 906 _AlgiPrs Drive North west Yelm WA 98597 (906 Yelm Ave Fast. Parcel # 22730110204 Please confirm receipt of this application by fax, mail, or email at your earliest convenience. Once accepted, please direct all permits and or other pertinent information to Thunder Fireworks, attention James Bland. If any more information is required please let me know. You can contact me via email, or phone at 253-875-0700 or fames ~thunderfireworks.com. Sincerely, ~~~ James Bland Thunder Fireworks ~~~~~~ _ i i"?~ B Y: -------------------- 5207 - 187th Street 1;., Tacoma, ~'1~:~ 98446 Phone (253) 875-070U • Faa (253) 875-0550 November 17. 2010 Attention Gary. City of Yelm PO Box 479 Yelm WA 98597 RE: TEMPORARY USE DESCRIPTION Dear Gary: We are requesting temporary use of the parking lot at 906 Algiers Drive North West Yelm WA 98597. (906 Yelm Ave East. parcel # 22730110204. We will be setting up a 10'x20' trailer for the use of class C 1.4G Consumer Fireworks sales. The fireworks trailer will be open to the public starting December 29`h, 2010 thru January 1, 201 1. There will be electrical usage, such as; cash registers, credit card machines, overhead lighting. All appliances tivill be piugg.d it~tu an outside genetater using approved extension cords. There will be a minimum of one person on site 24 hours a day. if you have any questions or need any more information please call me at 888-900-7799. Thank you for you time. Sincerely, %..~i~~/ James Bland Thunder Fireworks 253-875-0700 j ames@thunderfireworks. com 5207 - 187th Street E., Tacoma, WA 98446 Phone (253) 875-0700 • Faa (253) 875-0550 ACORD,~ CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDD/YYYY) 11/29/2010 PRODUCER (425) 454-3386 FAX (425) 451-3716 Arthur J. Gallagher Risk Management Services, Inc. P . O. Sox 367 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Bellevue, WA 98009-0367 INSURERS AFFORDING COVERAGE NAIC # INSURED Thunder Fireworks, InC. INSURER A: Jame3 River Insurance Co 5207 187th Street E . INSURER B: TdCOma, WA 98446 INSURER C: INSURER D: Id Sl1FNi L'. VERA ES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYpE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMBS ~ GENERAL LIABILITY 000457200 11/15/2010 11/15/2011 EACH OCCURRENCE $ 1, 000, 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ ,rjQ ~ 0 0 0 CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ A PERSONALBADV INJURY $ 1, 000, 000 GENERAL AGGREGATE $ 2, OOO, 000 GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMPfOPAGG $ 2, 000, 000 POLICY PRO LOC JECT AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON•OW NED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLALIABILITY 000457220 11/15/2010 11/15/2011 EACH OCCURRENCE $ 9,000,000 X OCCUR ~ CLAIMS MADE AGGREGATE $ 9, 000, 000 A $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LJA81LffY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS Location: 906 Algiers Drive NW, Yelm, WA 98597 The City of Yelm and its employees and Yelm Plaza LLC and its employees are included as additional insureds but only as respects the operation of the named insured per policy form EG2032US 0109. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRRTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Yelm BUT FAILURE TD MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P . O . BOX 479 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Yelm, WA 98597 AUTHORIZED REPRESENTATIVE ~(' ~ Dave Harman/JOANNE '~' / "~"'-~' ACORD 25 (2001/08) ©ACORD CORPORATION 1988 City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360)458-3144 Applicant: Name: THUNDER FIREWORKS Address: 5207 -187TH STREET EAST TACOMA WA 98446 Property Information: Site Address: 906 YELM AVE E Assessor Parcel No.: 22730110204 Subdivision: Contractor Information: Name: THUNDER FIREWORKS Address: JAMES BLAND 5207 -187TH STREET EAST TACOMA WA 98446 Contractor License No.: Project Information: Project: FIRE WORKS Permit No.: 20100070 Issue Date: 4/09/2010 (Work must be started within 180 days) Phone: 253-875-0700 Owner: TYPE PROPERTY OWNER NAME Phone: Expires: 0/00/0000 Lot: Description of Work: CLASS C FIREWORKS TENT FOR PERIODS JUNE 28 THRU JULY 4, 2010 AND DECEMBER Z~ THRU JANUARY 1, 2011 906 ALGIERS DR NW, PARCEL 22730110204 Sq. Ft. per floor: First Heat Type (Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor Fees FIRE THUNDER FIREWORKS $ 35.00 TOTAL FEES: S 35.00 Applicant's Affidavit: 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 an~J,jestLctions of record. If applying as a contractor, I further certify that I am currently -11WUKJl~Y 1 ~ S $35.00 ey im Dev. Dept. _ Dept. Date No. Upon receipt of the license application and $35.00 payment, the City of Yelm will conduct an inspection of the premises for building and fire code conformance. Upon approval from the Yelm Building Department of said premises, the City Clerk's Office will process the application and mail license to applicant at address listed below. Application is hereby mande for a Business License for the City of Yelm NEW BUSINESS L.~ NAME CHANGE/MAILING ADDRESS CHANGE ONLY DATE February 22, 2010 BuslNESS NAME Carla Hamrick NATURE OF BUSINESS Retail sales of 1.4G consumer fireworks BUSINESS LOCATION ADDRESS 906 Yelm Ave East Parcel # 22730110204 MAILING ADDRESS 5207 187th St. East Tacoma VVA. 98446 ANTICIPATED OPENING DATE June 28th 2010 / December 29th 2010 DAYS 8< HOURS OF OPERATION June 28th to July 4th 9:00 Am to 11:00 PM OWNER(S) Carla Hamrick Birthdate 5/12/80 MCkenna WA 98558 City State Zip TELEPHONE 253-431-1671 253-312-6215 (Business) (Home/Emergency) CONTRACTOR'S REGISTRATION NO. NA (If applicable) THURSTON CO. HEALTH APPROVAL NO. Nn STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI) 602-837-040 Signature Date February 22, 2010 CITY OF YELM PO Box 479 Yelm WA 98597 (360) 458-3244 OFFICE (360) 458-4348 FAX www.ci.yelm.wa.us APPLICATION FOR BUSINESS LICENSE Social Security No. 533-86-4334 Address 9702 356 st S. CITY OF YELM BUSINESS LICENSE APPLICATION Eff. 5/08 APPLICATION FOR RETAIL FIREWORKS STAND PERMIT TO: Governing body of city, town, or county in which DATE OF 2~22~1 fireworks stand will be located. APPLICATION: Applicant Name: Address, City, State: Carla Hamrick 5207 187th ST. E. Tacoma WA 98446 Sponsor (If other than applicant): Address, City, State: Same as above Same as above Location of proposed fireworks stand: [Enclose drawing of stand location] 906 Algyers Drive NE. Yelm WA 98597 (906 Yelm Ave East ) Manner and place of storage prior, during, and after sales dates: In Stand With Security State Licensed Fireworks Supplier: Thunder Fireworks FIREWORKS STAND PERMIT For The Fireworks Sales Year Of: 2010 (Must be conspicuously displayed at all times while the stand is open to the public) By virtue of having been granted a license by the State of Washington and this permit from The City of Yelm as the local governing authority, the named person, firm or organization is hereby authorized to sell U.N. 0336 1.4G Consumer fireworks at the location designated herein between the following date and times: Sales For July 4tn Sales For December 31St From: Noon June 28th 2009 From: December 29, 2010 9:00 am To: 11:00 PM July 4th 2009 To: December 31, 2010 - 11:59 pm sponsor: Same as above Location: 906 Algyers Drive NE. Yelm WA 98597 (906 Yelm Ave East ) /s/ /s/ Signature of Official Granting Permit Signature of Applicant Agency: Date: Permit Number: Licensee Name: Carla Hamrick License Number: WSPFL-01342 3000-420-UIJ (Rev. 2/05) CITY OF YELM COMMERCIAL BUILDING PERMIT APPLICATION FORM Project Address:906 Yelm Ave East Parcel #: 22730110204 Zoning; Comercail Current USe: Grocery Store/ Retail Proposed USe: Consumer Fireworks ^ New Construction ^ Re-Model / Re-Roof /Tenant Improvement ^ Plumbing O Mechanical ____ AEite Prevent/Suppress/Alarm^ Other_ ____ Project Description/Scope of Work: Retail sales of 1.4 G Consumer Fireworks Class C Project Value: NA Building Area (sq. ft) Parking Garage NA 1gt Floor~soo' 2"d Floor na and Floorna Building Height na Are there any environmentally sensitive areas located on the parcel? n~ If yes, a completed environmental checklist must accompany permit application. ~ • Yelm Plaza LLC /Great Wall Propertise Inc. ADDRESS ~azso east valley Hwy. EMAIL NA CITY Kent STATE wa, ZIP sso3z TELEPHONE 1425-982-0049 i NA LICENSE # ADDRESS EMAIL CITY STATE ZIP TELEPHONE ~~E3~ ~ ~~ °, ~ TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRi,CTGR'S LICENSE # EXP DATE CITY LICENSE # NA TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # ~~~.~' ~R ~ TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # Copy of City Mitigation documentation (TFC). I 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 taws, rules and regulations of the State of Washington and the City of Yelm. ~~ ~ / ~/y ~~ f/ ~~~ ~ 2/22/ 10 App icant's Signature ~-! Date Owner /Contractor /Owner's Agent /Contractor's Agent I 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 lu5 retm avenue west (360) 458-3835 PO Sox 479 Yelm, WA 98597 (360) 458-3144 FAX www.ci.yelm.wa.us Washington State Patrol 1 1 1 5 0 Fire Protection Bureau - Office Of The State Fire Marshal Fireworks Stand License Washington State Fireworks License License is Non-Transferable and Valid for Only One Stand Licensee Information Carla Hamrick 5207 187th Street East State Fire Marsha' Signature Tacoma, WA 98446 License Number: WSPFL-01342 Detach this ~allet card and carry with you for Stand Information Contact Person: Carla Hamrick Phone Number: (253) 431-1671 County: Thurston D_ ate of Exnit•ation Date of Issue Stand Number: SN-04875 January 31, 2011 March 18, 2010 Stand Location: ~Q~o ~~c i/fin ~ ~~iv~ /d/+'~ - y~I.~-s Lr/~ p~~7 3000-420-012 (R 9/OS) verification of certification. Washi Igton State Patrol 1115 0 Fire rotection Bureau Office Of he State Fire Marshal Licensee: Contact Person: License Number: Stand Number: For One Stand) Location: State Licensee Signature • auu~ [ t3lit8 'OH gOf ] ~5~9T t1H.L OTOZ/8T/iT 11!16/1010 ~ 14.11 FAQ 2538750550 Thunder Fire~arks FlRE'9VOIZK5 TENT LEASE .E1.G~i;1V(E1VT THIS LEAST: AGRI;EMEr1T "Lease Agroement'~, made this 1 Sttt day of Nove~utber 201 betwrcn Yelm plaza LLC. A Washington cotporntion hereinafter designated the `.and Ovmes" ::nd THUNDF.A FIItE't~V4RKS, hereittafitcr designated the "i..eSSe~e." WIITIESSES: That tfte said Land Owner does by thew presents !ease to Lcssrx ~ fotlvwing: 1. PR1~II3ES: 906 Algiers 17rive North west, (906 Yelm Ave East) ~ [~ tbC diagram maciced F.achi'isix "A". 2 December 20, ZOlO thrti ]snttary 3rd 20 J 1 3. RBNY~ which t-eaocicta Lsasoc t't'ent osfainlQS necessary pemuts, the react wilt be refunded Iu full W Lessen a. si=.c~nuTY~ DA~AG~ J3~oslr: wed. 5. SUi3LET: Lessee shall not assign this Lease Agreement o[ arty part hereof without ~e prior written coa~cnt of Land Owner. ' 6. L,ESS]~sE'S OBLIGATIONS: S.es;x shall: (a) Asstmag foil liability for arty and all claims, damages or of acaraa arising during the term of this Leese Agr~enl caused by Lessee, it'd agents, eorstractnrs, wb-oo~tfraeio+ra, guests and inviteGS, and hold ' Land Owner harmless there from. (b) provide Land Owner with evidence of [lability insurance effective for the Term in act amount oJ'n~t less the two million doIIars (~~~,~.~) with x rider lisfitig Land Owner as as additional insured. Lc,3sea will ptevide documertutiarr W Lend Owner showing flee ittsuranee coverage is active prior fp the oomtncaoGC»e:rt etf ffiny nse of tfte Premises far the f«m of'the Lease. {c) Properly dispose of ail rubbish, garbage and waste ~esated by Lesseey its agents„ oeatradots, sub~ontraetors, guests and fnvitees, is a clean and sanitary rnartnu: (d) Not restaict the flaw of tt~ic (pedestrian /vehicular). (c} Comply with arty end all Jaws, rules, regulations and regnii~matzts imposed ttpan it by arty gaventmettted agency governing rho Lessee's proposed asa of the Premises and pose any required performance bonds with the Jocat government. Any pam;t$ or licenses required of the >znaer~s~d iessec shat! 1~ obtained by the Lessee priort:~th~ commencement of the Turn of this agzteemcnt. ~ OO1I005 J/lr,~/nerd LEASE AGREE1vlENT ~ PAGE 1 C00 ~ [ 66T9 'OH HOP J b5 ~ 9T HILL OTOZ/8T/Ti 11/16lZO10 TUE 14;1 FAg 25387b0550 Thunder Ffz'e~orks X003/405 (~ N'ot intentionally or negligently destroy, dtPace, damage, isnpsir or Remove any pert of the Premises, nor to permit any of its agents, contractors,aub-contractors, guests and invitees or other persons actin under its control to do so. (g) Suffer na lien to arise or be lYlcs b3' arty tracing autk~oiity or by any Contractor, sub-oontracxor, or supplier or labor or materials used he Lessee or Any other third party on the 1'ra:nisCS; a»d, in the event any such lieu or claim of lien is filed, cause the same t0 be satisfied or discharged in full witbirt thirty (30) days following the filing thereof. 7. USL: Licensee will use the Premises to conduct retail sales of approved "1.4G" or comuronly {mown as Class "C" aacllor Conavmer Fircworxs along with those activities atteadan~ to that Intended ase. Lessee may place terrrporaty striping or cones And a teat as rte~esssry and erect appropriate 'c and will remove the soma at the eIId ot'tltc term. Lessee shall ~t use the PremlSCS for any illegal purpose, Lessee agrees m confotrn to all style, county and mtmioipal codes, S4rt11teS, oIdlnaACCS and rcgvlatians concerning the use and occupation of iha Premises and to obtHin the prior receipt of approval of authorities of cosppetdnt jurisdicdion for its intended tut of the PremisCS with copies thereof to Land Ovvact. Y2'the J,,essee is unable fA procure the necessary firework pe;tmits fivm the StatC o#'Washington and the City of Xelm to oparaba a fireworks tent on the above mentioned Fremises then this LeasC Agrcttnent shall be null and void 8. ALTERATIONS: LioenS *w^ aCCCptS the Premises in its pereseat Conditions, "AS IS, W1iF~ YS, and with NrL FA,iTLTS" Lessee ogees not to make alterations to the Premises with the prior written consent of the Land Owner 9. S URIt}'s1~1Dl.R: At the e.Xpiratio» of said terns of this Lease Ag~eemenl wit l surrender the .Qrednises to Laad OvvXter in a condition equivalent to or bolter that whin first made available to Licetrscc. I0. ACCESS; Losscx will have unlimited access bo the Premises daring the germ of the Lease at the erttr~artcc /exit shown on the attached lixhibit A. ! 1. TAXES: Land Owner ahnll be solely reaponable for any taxes o>: the real property. Lessee shall be solely reapoasr'blo for any taxes on its pezYOna! property and/or the conduct of its activities. I2. COSTS, ATTORNE'Y'S FEES AND VENYJ1r: If, by reason of any default or breach on the part of either party in the performance of any of the provisions of this aprcement, enforcetuent of any term of this Lease is sought, whether ar sot legal activti is instituted, the lasing patty agrees to pay nlI reasonable costs and atto~naey's fees of the pterrailiag early in caanecdon therewith. In the event any claim for personal injury, death, property damage, or other alleged liability is asserted against Land Owner, Lessee ogees W defend and hold Land I,LxAS]s AG~tEEM£NT - PAGfi 2 ~ y/~Jr-~~n I;00 [~ (66T9 'OK gOt) 65 ~ 9T fl$L OTOZ/8T/TT 11!16/2010 ~ 14:12 FAI 2538754550 Thunder Fire~orks Owner harmless o£any such claim, inchsding attocaey's fees and legal costs. tt is agreed that the venue of say I¢gfl] action brought -mder the terms ofthis agreement shall be Pierce County, State of Washington. 13. NpT1CES: (a) Notices to Land Owner shall he delivered, permnally or by cect~ed mail. postage prepaid, addressed to Land pwAer ai: Ysla~ P1ara LLC. 18230 East Valley Hwy.Suite 108 >z"~,t wA 9so32 (b) Notices to Llcensces shell be delivered, personally or by certified mail, postage prepaid, addressed to licensees at: 'thunder Fireworks 5207 187m street E. Tacoma, WA 98446 P;253.875.0700 P:253.87S.OS50 14. EXECUT70N: This instrument is signed in multiple identical copies, airy ood of which will eu#~ice for legal purposes as air origibal. IN SIGN)[T•TG 7'RIS IN5TT3MENT EACIii PARTY ACKNOWLEDGES AND REPRESENTS T'O THE OTHEK SIGNEYLS: (a) That the person signing has read the instrument in its entirety. (b} That the person signitmg this docua-Cnt has authority to do so and [o bind his/her princip$l, ru-derstands that this inxtrarner~t constitutes and important and binding legal contract, which fixes and determines certain legal and obligations of the persons signing it. (c) 'That no provision o#'tflis document can ba changed by reference to any oral representations or agreeaaeats. iN VVYTNESS RTJE~><tF.OF, the Lessee snd Land Owns have each hereunto signed this inshumant in duplicate the day and year firs! about written. LAND OWNEK: LESSEE: Thunder Firevrols. ' ~.iy-~/ ~'~ Cam'.. By: James W. Btaad Retail Mafiager. LfiASE A(~T~E1v~NT -PAGE 3 ~ 004/005 By: 500 ~j (66T9 'OH gOt~ b~ ~ 9T f1A.L OTOZ/BT/TT 11/16/2010 TUE 14;12 FAQ 2538750550 ~tunder Fireworks .. ti::~ ~ . ~•~ '• X005/005 .. .M,..~::~~.:~~. . ~~ /1.~ /6~~ ~ - 7,o~D