20110120 Permit Pkg 01142011City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No.: 201 ~ 0120
Issue Date: 1N4f2011
(Work must be completed within 180 days)
Applicant:
Name: ORCA NW
Address: P O BOX 2246
YELM WA 98597
Property Information:
Site Address: 1 f1R FIRCT ~T C
Phone: 360-789-4047
Owner: TIM AND NANCY LARSEN
Assessor Parcel No.: 64400500800 Subdivision:
Contractor Information:
Name: ORCA NW
Address:
P O BOX 2246
YELM WA 98597
Phone:
Contractor License No.: ORCANN1964K1 Expires: 5/27/2012
Project Information:
Project: TI
Description of Work:
Sq. Ft. per floor:
Fees:
TI ADDING COFFEE SHOP AND NEW OFFICE
First
Second
Third
Garage
Basement
Heat Type (Electric, Gas, Other):
Lot:
Item Contractor Fees
MECHANICAL ORCA NW $ 39.00
PLUMBING ORCA NW $ 41.00
COMMERCIAL ALTERATION ORCA NW $ 900.03
TOTAL FEES: S 980.03
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 includi~-those~governing zoning and land subdivision, and in addition, all covenants,
easements and restri~tipns-t5f record. If applying as a contractor, I further certify that I am currently
registered in the-5taf .p~\Washin on. ~ / ~
Signature .~ ~'~, fate ~ - ~7 ~/
Firm
L/ P
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: r ~I 6 ;~ r; f S? Parcel #: 6 y ~~q Q S' p/ d p O
Zoning;
Current Use: S ~ rP f G e ~^ (Proposed User
- New Construction ~Re-Model / Re-Roof /Tenant Improvement
„`Plumbing Mechanical Fire Prevent/Suppress/Alarm Other
Project Description/Scope of Worka'n ~>`Q ~ d ~ , ,~ , r„ ~~, r
Project
04
Building Area (sq. ft) Parking Garage 15~ Floor 3O ~ 2n° Floor 3rd Floor
Building Height IZ - (y '
Are there any environmentally sensitive areas located on the parcel? ~~ If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER/TENANT NAME: / ,1~, r ~'1-•Sc.~, ~
ADDR~y~S z~G~ ~~~~~~ ~~ S~~ E AIL
CITY YG STATE jv/J- ZIP ~~ TELEPHONE l~-~f5 -~~ E -
ARCHITECT/ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
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 111 be In accordance with the laws, rules and regulations of the State of Washington and the
City of Yelm.
r-i~-ri
Applicant's Signature Date
Owner /Contractor /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 da
~C~~~~~
105 Yelm Avenue
PO Box 479
Yelm, WA 98597
(36~) 458-8144 FAX
wrow.ci.yelm.ma. us
Copy of City Mitigation documentation (TFC).
COUNTY COMMISSIONERS
Cathy Wolfe
District One
Sandra Romero
District Two
Karen Valenzuela
District Three
THURSTON COUNTY
s~rrcE issz
October 13, 2010
Tim's Pharmacy & Gift Shop
Attn: Tim & Nancy Larsen
PO Box 5120
Yelm, Washington 98597
PUBLIC HEALTH AND
SOCIAL SERVICES DEPARTMENT
RE: PIan review -Addition of Espresso Service in existing building
Dear Mr. & Ms. Larsen:
I have completed my review of the plans and information that were submitted for the addition of
an espresso bar in Tim's Pharmacy which is located at 106 First Street South in Yelm,
Washington. The plans are accepted with the following conditions:
1. All building, planning, fire and electrical code requirements must be completed prior to
calling for apre-opening inspection.
2. Your menu consists of various espresso and other soft drinks, plus ice cream/milk shakes,
commercially made pizza and commercially made cheese cake.
3. Any expansion of menu, addition or change of equipment, or remodel of the establishment
requires review by this Department.
4. When milk is heated for the first time, it must reach at least 140°F. If any leftover milk is re-
heated, it must reach at least 165°F. If the consumer wants a cooler drink, fresh cold milk
may be added after the 140°F or 16~°F has been reached or exceeded.
5. Pitchers, spoons, and in use utensils must be rotated or removed from use on a routine basis
to ensure that residual milk product is removed. Temperature abuse of the residual milk will
be reduced when the container is washed, rinsed, and sanitized.
6. Blender pitchers must be washed, rinsed, and sanitized after each use. If time does not allow
this cleaning, the pitchers must be rinsed and stored in a refrigeration unit.
7. Espresso wands are food contact surfaces and must be cleaned/sanitized afte~r~~c}~ ~s~~ ~D
412 Lilly Rd. N.E., Olympia, Was QCT ~ 12dt0
{360) 867-2500 FAX (360) 867-2600 TDD (360, ~ -6384
taww.co.thurston. wa. usl~ealth
~-. ', r. , i'f
'. ~ ~~: f ••• .1 G is i i1
~ V.
Tim's Pharmacy & Gift Shop
October 13, 2010
Page ~ 2
8. All equipment should be NSF approved or its equivalent.
9. All floor, wall, ceiling, and shelf surfaces must be smooth, durable, nonabsorbent and
cleanable. The wa111floor juncture must be properly coved.
10. All exposed, unfmished wood in food preparation and storage areas must be properly sealed.
All lights in food preparation, service, and storage areas must have proper shields or guards.
11. Indirect drains must be provided for beverage dispensers, produce sinks, food preparation
sinks, ice machines, walk-ins, condensate from refrigeration units and any unit used to
dispense food/beverages.
12. Vacuum breakers or backflow prevention devices are required on all faucets having threaded
hose bibs.
13. This establishment will have only three sinks; a mop sink and a two compartment sink.
Espresso bars typically only have a few items to wash at any one time. You are approved to
wash hands in one of the sinks, rinse utensils and dishes in the 2"d sink, then wash utensils
and dishes in the under counter dishwasher. Your proposed menu does not include any
produce that would need to be washed before use. No food, such as produce, shall be washed
at this facility unless a food preparation sink (equipped with an indirect drain) is installed.
14. 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.
15. 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.
16. All refrigeration units must have visible working thermometers.
17. A food probe thermometer, with a minimum range of 0°F to 220°F, must be obtained and
used to check food temperatures.
18. 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
y , - ~ ~ r rbeen provided to the individual must be kept on file by the employer.
.,-
~w
412 Lilly Rd. N.E., Olympia, Washington 98506-5132
(360) 867-2500 FAX (360) 867-2600 TDD (360) 867-2603 TDD (800)-658-6384
www.co.thurston.wa. us/health
~ Tim's Pharmacy & Gift Shop
October 13, 2010
Page ~ 3
19. 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.
20. 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.
21. 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
know.
Category Square footle
Food Processor <500 Sq. Ft.
If you have questions or need to schedule apre-opening inspection, I can be reached at (360)
867-2571.
Sincerely,
~~~
Kay Massong, R.S.
Environmental Health Specialist
cc: Gary Carlson, City of Yelm
Orca Northwest Inc.
412 Lilly Rd. N.E., Olympia, Washington 98506-5132
(360) 867-2500 FAX (360) 867-2600 TDD (360) 867-2603 TDD (800)-658-6384
www.co. thurston.wa.us/health
youunei ~ orr ~ u
C~Nin,a3d~
11N~
aGbaotS
~u~hs! ~~
a~'}} ~
n ~~
,,,root' ~ly~l~
Gh!FS~xj
i,,.oo y
~~»~~
G~~tStr~
'J 8'~~ %~ i
- ~i
~I
,,4 ~i
,~
it
SN~
/ yt"P
.}S~x~ I1('~J'
~ ~-~J
-
Ref ~r5cr~(t~
b ~Ai+iMA ~_'
/ b
b
AreA
( '
N ~
°~
i ~-~J
Q~
;i,h
a ~
~ o0
~ T
0 . ~ °°
~
u
.a
3 ~~
V ~
~~~ ~ a
r
~ ~
"~
~ ~
~
Y ~ O
y v
~_
y2~'
I~,~~~a~ ~~waN
Y
N
o~,,~P'"yid ~N7
C
3'--~i
K counter stools fixed suppty alternate
seating meeting ADA requirements
T~-~ s
phar-~~~y
f 06 fi rsf S T
Yel ~ WA ~ ~ {f S~ o~
~- 1 Z
fx n fi~9
P
APP~t~•, ~~
-~~r .. .
~._._._.--~/ r1.
~t
~x `5t `~9P~'~~'~~
gf bble
Y„a -
~~ ~~~
8°'1a'
r- - ~_
N "r'°Q
,~,,ye
o,~,~;re
/ ~;
F'~ SiN~S L( oC
m
-__ f
Ne~v
---- - Drop of{
~!! ~~t' %~,.i ~ 3~ n( z~fi'~ ° j~ 1:i Pf.~^~' ;.Y.•'~ j~~~,fh ~ ~~; :i,T ;i+.J'~9'`~ ~ ~i'` ~v~
'% t ~ {1 , I
Dishwasher to be tied in after the
Grease interceptor. Afl fixtures to be
air gapped per code,
^.~
s
~l ~ '~
f
i
i
Urn
`~ s~ ~^
s ~h
;~
.~ r
s
~ `^ r
T `
a~
a.
v ~; r ;v-~~Jr
~~=srrr ~~ rya
.~ ;ter ~,~~ .},~~~` .us<
.ir'
i
n ~ ~
f
~ '
rs-~ r
r
r
_~-,.t
r
~=~ }
~~.:-~ co
---_..
t
r/fir't7 Cl'' ~~'u'•~~ '~
Ti V~ S P~ cz~r~Gt.,GY
c) ~.~ ~~f..,l ~.~~ ~
~Q ~r\rS~ir~°1
.^.~
10 ~.^t~Sts~g
i/v
`'Ci
n
v
~g~gF~g~
B Y: --------------------
~f C,.~,',:n ~'-,t
C
V~
I
,• 1
.• ' M~~rO .i•
W AVf
I
__ _w.
~ M__.__ ._ _.._. __ ._ _ ._ ~..--- -
_.~ _-
'r +
I
~,~ ~ I
~~
~ r~~~
4 r,.
N 1 f
~"~
M~!
i
i u°L
i
r,,
Ic .
~__.:
!q'~ `,
c ~'
,. ~ ;~
(t ~<<
> .~
~.+ESt ~~2vu'~rC'~ ~E.~~C~~S
1 ..~~~~ c..y, ~otfce
...__._.
_._. f ~.~5 s „,a i l
7(P ~~'ir,a/
CrP.o ~~.~i„F
S~t P `V ~ ~~
r ~n~/
S,!.,~i
~ _. .._._.._...... ~~~/~ /~r¢ _
C ,. I O
j A -~.i^. _ _.._._.~. _I~
r ~'
~lq~,c ~ ;
S'`I' S ~~
V , _.. __ s
^ y
;.~~ r~ ~~
T • ~ S p~ a.rr~A..~ ~`
~ ~
.`
i
i {
7 ~
`` J 1+ ?
~t i i
\ ~
~1 Ti 'y, ~ 1
..._~~ ;
_ 4
a € '?
v , ?~.
~+.
i3 ~`~
t ~ ~.
....- I
v
)i ..r
Jf)~+;"' p': ~i` r is _`~.t
~ ~ ~~~~~~
B Y:
ENDURA® GREASE 1VIANA,GEMENT
The ~ ,"~
ffiffi
Grease Interceptor
Uses Standard
Mechanical Couplings
EZ - open Recessed Silicone
I ~r~}~inn SvcTam Cpal
;, ~-: .,
ice: ~~~'~~ s~:~~.
- '~ ~ ;~~r Injected molded in
_ _ ~~~jtv engineered thermoplastics,
``~~ Endura° will not corrode,
~u~~~~iY rrD chip or peel, even underthe
a/Availabilitys~Reliabilityar'[lur8bility most severe applications
to grease
~~~ management
PDI & MEA
164-Oi3-E
Approved
IAPMO ListedR
•uo ~.r.~p hri~y to.
15 Glfa tr~N.'1.0~~
Patented Baffle
• discharge at 104 ~C X220 (7 .
~; =_;tigiitvyeight.and.strong, Eniiura!• ~~ ~.~ ,
~~';models.weighupto6096•le:ssthan.~ ~~'~.
-• :.directly equivalerif metal competitors.
.. ~"~'-offers ease of installation; vansport~=' ~.
"-~ and storage :: ~ ~ •• •
. "'~~ Design
• Compact, durable, user-friendly solution
• Molded one piece tank eliminates
. '~ ~:seams and potential leaking . ~ '. ~~.' . ~ ~:
.:Can withstand continuous ~ '
o • ....
pporfs 44Q pounds of ~ ~ .
and-light dtttytraffic ~ ~ ~~ . '
using mechanical joint' :: :;
illowing:for use'of ~arious~ .
www,endulra+nterceptor.com
o~ OAHaxrs eenyoar
~ ~a s~zl ~~~ Nos~~a3~ WdlO~i,l ~~IOZ 'tz ~noN
~~
~ Grease Interceptor
DNfuser
baffle ony
used;n 35
and 50 GPM
modals
Coruractor shall install a Canplas Endure' Grease interceptor, Part No. (fill'in).
A flow control with a rate Of gpm will also be installed in auordance
to manufacturer's instructions. The unit shall be comprised of enghteered thermoplastics to withstand
operational temperatures up to 220°F (104°Q and incorporate a {id with the apabiliry of wpporting
440 Ihs. (200 Kos). The unit will be suRported by a 10 year manufacturerY extended warra-It}r. The grease
interceptor.
TANK DIMENSIONS
grease
GPM/lhs 15/30 .20/40 •25150 LO 25/50 ~ 35110 50/100
A 23b' (600mm) 23.6' (600mm) 31.0" (787mro) 23b°(600mm) 31.0"(787mm) 31.0" (787mm)
B 115"(444mm) 17S•(444mm) 235" (591mm) 17S"(444mm) 23S•(S91mm) 23.5" (59Tmm1
C 3S' (89mm) 3S• (84rrxn) 4r (102mm) S.1'(104mm) S.0•(127mm) 5.0" (127mm}
D 128" (315cnm} 128' (325tnm) 7' (UBmm) 12.2' (310mm) 125' (318mm) 185' (469.9 mro)
E 163` (414mm) 163" (414mm) 11' (279t1-m) 163' (414mmJ 175' (444mmI 235' (596.9 mm)
FLOW CONTROL DIRAENSIOhl5
Connection 2"hxh 3"hxh 4'hxh
icon Pipe Size
(Soh+encxreld)
a 3.0' 4.23• 6.13'
(lb.2mm) (107.4mm) (155.7mm)
B 3.84" ~ 593` b.84`
(975mm) (i51mm) (t73.7mro)
c - - -
repe['171FC
AIR INTAKE DIMENSIONS
2'spq r< h 3•spg x h 4°spg x h
2.91' z.6r 3.19•
{73.9mm) (67.8mm) (81mm)
2.71' 4.01' 5.04'
(b8.8tnm) (t01.9mm) (128mm)
z.z4• 2.2r 2.72"
(36mm) {57Jmm) (69.1mm)
FLDW COMROC AIR INTAKE TEE
T - ~~~ -
j3 r
i y
--A-s) IrA>I
3' VFASIOPI ILLljSTRI-TED
-- U5 Gallons Per ItUnute (GPM) 15 ZO 25 lA 25 33 SO .
CAPACITY -Pounds 30 40 50 50 70 100
l)lresPerSer4ndMi7 0.94 11b ~ 1.6 ~ 1b 2.2 31
CAPACITY-fGlograms 13.6 18.1 2L68 IZ7 31.8 45.4
A+alageEPfitkncy%(ASME112.43) 97.1% 97.196 92516 98.6% 93.946
Put Number
• 3915A02 i` 3910A0 3925ADI10 392SA02 (2°)
3925A03 (3') 3935A03 (3h
393SA04 (4~ 3950A03 (3')
3950iA04 (47
Grease (apatiry 165 (~ actual
OperatictgTempendueC~pt6lGtlts 65 (295)
22D'F(104'Q 1b.4 (34b5)
220'F(104'Q 53.4 8412)
220'F(104'Q . 74 (33b)'
210'F(104'C) 1385 (62.8)
220'F(104'q 172 f553) •
220'F(104'Q
Surface load Capat9ry 410Ibs a00 kgs) 440 Ihs {200 kgs) 4a01bs (200 tgsl 4401bs (2001ogs) 410 I6s (2001gs) 4t01bs (200 kgs)
Unit weight Ifiuply) ' Z3 Ibs (10.4 kgs) 231bs (10.4 kgs) 23.9 IbS (10.55 kgs) 2316s (10.~ k js) 45 0a (2DAltgs) 6016s (21,2 kgs)
Utwid Cajucity 21.6 gal (8i.8 U 21.6 gal 181.8 U 18.9 gal (71S4L) 21.6 gel (61.8 L) 39.4 gal (149.1 U 52.0 gal (19J U
Cmine0lleq lj2t (medlatiaan
(110 mm ira8abk On Rquest) Y
~ Y 2'
~ ~ Y (3925A02)
3•(3925A03) . 3'p935A03)
4'(393SA04) 3'(3950AQ3)
4'(3950A01)
' Max ~paciry talctdated based On data at PDI 6101 test approrel. All other models/dab quote figuresatASME 112.143 Breakdown.
~~
%pU-~
Suppliers A'dn~dlres~
-'~~~
~~ ~~ S~~ ~
~; d ~ 65`''~~~
z ~a atiz l ~°rv
6npiu4tdustriaLtd hnplisLLG ~ ~ ~ ~ ~~V c`' n
P.O. Boot 1800, s0oveterans Orlve t 102 Past 53rd Ave ~
u
Barrie, Ontarla Unada l4M 4V3 SuRe 200, Denver, CO, US.A.80239
Tel• (los) nb3361 Tel; (303) 371191 e
Tell Free: t-800J67~5300 ToM FreC 1.067-5307
Fact: POs) 72lr2186 FtgG (303j 373-1923
B Y _ _
cr~ooos~o~cr+ a, C?Alrttxi5 rompory
NOS(1J~3j Wd~O~ZI GIOZ ~tiZ ~AON