20110130 Permit Pkg 01262011City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: Washington Federal Savings
Address: 425 Pike St
Seattle WA 98101
Property Information:
site Address: 9301 Cullers Rd SE
Assessor Parcel No.: 21724110101 Subdivision:
Contractor Information
Name: Washington Federal Savings
Address: William Glenn
425 Pike St
Seattle WA 98101
Contractor License No.:
Permit No.: 20110130
Issue Date: 0/00!0000
(VVortc must be completed within 180 days)
Phone: 206-626-8507
Owner: Washington Federal Savings &
L
Lot:
Phone:
Expires: 0/00/0000
Project Information:
Project: DEMOLITION
Description of Work: YELM FIRE DEPARTMENT PRACTICE BURN
Sq. Ft. per floor: Heat Type (Electric, Gas, Other):
First
Second
Third
Garage
Basement
Fees:
Item Contractor
DEMOLITION Washington Federal Savings
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 and strictions of record. If applying as a contractor, I further certify that I am currently
registered in t ate of VI'~shington. ~,/~
Signat /J Date ~~ ~ ~!/v ~~
Firm
Fees
$ 0.00
OFFICIAL USE ONLY
Sets of Prints:
final Inspection:
Date:
By:
PERMIT #:
JOB ADDRESS:
OWNER:
CONTRACTOR:
WORK DESCRIPTION:
TYPE
CITY UTILITIES
OTHER UTILITIES
DEMOLITION FINAL
~, .~ . ~.... .. .Il!
CITY OF YELM
Community Development Department
P.O. Box 479 -- Yelm, WA 98597
(360) 458-8407 ~ (360) 458-3144 FAX
20110130 DATE ISSUED:
9301 Cullens Rd SE
1~ederal Savings & Loan
BUILDING
PERMIT
INSPECTION
CARD
/ • ZCo •2C~Cl
r ecterat
cYc Loan
RESULT DATE DONE
All Marked Inspections
Must be scheduled prior to covering
Call (360) 458-8407 for Building Inspections
Call (360) 458-841 1 for Sewer lnspections
All other jurisdictions' inspections must be complete before you call
~~
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
Project Address: 9 3 O 1 Cul 1 ens RD SE Parcel #: 217 2 4110101
Subdivision: Cullens Road Platlot#: Zoning;
R6
u New Construction u Re-Model / Re-Roof /Addition u Home Occupation Sign
u Plumbing u Mechanical u Mobile /Manufactured Home Placement ~ Other
Project DescriptionlScope of Work: demo 1 i t i on
Project
Building Area (sq. ft) 1'' Floor 2nd Floor Garage Deck
Basement Carport Patio
# Bedrooms- # Bathrooms Heating: GASIOTNER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER NAM .as ington Federal Savings/William Glenn
ADDRESS- a~~ P;kP ~T EMAIL
CITY Seattle STATE WA ZIP 9810 TELEPHONE
GITY
EXP
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LIGENSE # EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable.
I hereby certify that the above irtformatlon is correct and that tiw construction on, and the occupancy and the use of the
above described property will be in accordance wkh the laws, rules and regulations of the State of Washington and the
Clot of Yelm. w
/~ ~ ~ 2 ~//
Applicant's Sign re ~ Date
Owner /Contra r wner's A en Contractor's Agent (Please circle one.)
All permits are non-transferable and will expire if work authorized by such permit is nat begun
within 180 days of issuance, or if work is suspended or abandoned for a period of 180 days
105 Yelm Avenue Weat (360) 458-385
PO Bos 479 (36D) 458-31 ~~ FAX
YeIm, WA 98597 wtvru.ci.yelm.tua.ua
Sandy Bailey
From: Gary Carlson [garyc@ci.yelm.wa.us]
Sent: Monday, October 04, 2010 3:07 PM
To: Sandy Bailey
Subject: RE: Cullens Road -Practice Burn
Attachments: Residential Application.pdf
Sandy,
Attached is a residential building permit application. A demo permit for a residence is an option as
other. Please note it is a demo under scope of work. The permit is $50.00 and can be issued at the
counter is you coordinate with us and have your ORCAA permit. Any questions email is the best way
to contact me.
Gary
From: Sandy Bailey Lmailtoabailey@novastardev.coml
Sent: Monday, October 04, 2010 2:32 PM
To: Gary Carlson
Cc: Wayne Potter
Subject: Cullens Road -Practice Burn
Gary,
I'm following up on the voice mail message I just left you. I need to find out exactly what kind of permit we
need to obtain from the City of Yelm to allow the "practice burn". (We are aware that we must obtain
approval from ORCAA as well and we are pursuing this.)
do you have an application form we need to fill out? What are the fees? How long would it take to obtain the
permit?
Appreciate hearing back from you.
Thanks!
Sandy Bailey
Project Coordinator
Novastar Development, Tnc.
Barghausen Consulting Engineers, Inc.
18215 72nd Ave 5
Kent, WA 98032
425 b56-7400-direct
425 251-8782-fax
Olympic Region Clean Air Agency
2940-B Limited Lanc NV~/
Olympia, WA 98502
(3G0) 539-7610 • FAX (3G0) 49i-6308
port Angeles office (3G0) 417-14GG
Raymond Offtce (360) 942-2137
~vww.ORCAA.org
Demalitiota. Permit
~ Commercial Structure -Permit fee: $b0,00 -10 working day wait period
j) Owner occupied residential dwelling -Permit fee: 535.00 -Prior Notice 611•~ lt~rn ~.
.,.,<.. ,. ~,nT . Cen~
1-nVi>'Jntr VWlvrrl.
Name: Phone: 0 626-8507 Email:
Washington Federal Savings FAX: Mobile:
&IailinR Address:C/O Novastar Development InC Ci[y: State: Zip:
98032
lezis 72nd AV£ S Kent Wp,
Site Address: City: State: Zip:
9302 Cullens RD SE Yelm WA 98597
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Onsite Contact: Phone: illobile: ( )
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Mailing .address:
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of Structures
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asbestos
DEMOLITION P,RO ECT CATEGORY
[ )Complete Demolition
jx] Training Fire - Firc Agency: Cit of Yelm Fire be t
[ ]Renovation, Alteration, Remodeling, fiiaintenance, or other Construction
Emet enc -Additional IFee of $80.00 must be accom anied b Government Ordered Declaration-Commercial only
I bane read and a+i!! abide by ibr eonditlonr ret forth in thin permit and any addrndum therrto. I do brrrby ratify that
a!! identified arberivr has brew remored and the l~fornration !n tbir aJiplioatioa and tx,~plenrental data drrerebed brrain
ir, to the Bert of my knowledge, accurate sad completr.
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Applit;ant Name Signature Date
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Datc~l~gTicattonilt~cce~it~e
Payment Info:
[~ Approved
tlsbcstos Permit
` [ ]Cash [ ]Disapproved Permit # AS$00
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10/21!08 UV b;lt
~.2/2.1/~,010 08:44 FA% 425 251 8782 BARGHAUSEN ENGINBERS
2940 8 Limited lane NW
Olympa. WA 98502
Phone: (360) 539.7610
FAX: (360) 491.6308
wwa+.orcaa.arg
Training Fire
Request
~ ooz/ooz
APPLICANT NAME/TTI'Ll:: WasttingtOr Federal Savl-ti9ttIWflAam Gletut, VP Spedal Assets Oepl
.'-PPLICANT /FIRE PROTECTION AGENCY: ~ of Yelrn Flre Dept
APPLICAN'I'ADDRE$S: C/O Novastax Develo ment: Inc 18215 72nd AVI: S Kent WA 98032
TRAINING ~'-DDRESS: 9341 Cullers RD SE Yelm WA
.PROPOSED TRAINING DATE:
The following itetne are eortdidona that must be met prior to the ignition of Tice fighter training fires. Pleaee
complete the checklist below wind provide documedt>ldoa where Aeceeeary.
/ N I.QCATION OF FIRE is not in as area declared to be in an air pollution episode of any stage of
impaired air quality.
/ N NOTICE OF FIRE TRAINING EXERCISE provided to odjoiniag property owners and additional
persons as necessary.
/ Ai dLL STRUCTURES to be set on Eire are identified, and all structures on same parcel rat ro be set on
~.+ fae arc idendtied (pliiu~ prottde drlarbJ.
y N ASBESTOS 1NSPEC'I'ION eondtuted (plrave~+rdr wd!/rx do~awnJariox).
/ N ASBESTOS datected~ -, ,,,,.__.__-
/ N ASBBS7'05 NOTIFICATION and retrioval completed (~harr lxbmr e+opy oJna/}ftratiox),
~`1(/ N i19ERCURY-CONTAINING THERItifOSTAT$ AND SWITCHES identified, propcily removed•and
VV disposed of is a safe. mannee. (Contact your locsJ County Solid Waste Depacsment For more infotmarian)
/ N AtATERIAI:S NON-ESSENTIAL TO TRAINING removed, including, but not limited to composition
roofing (APTBR asbestos inspection). carper, linoleum, fumituce. And floor tile.
If you hAVe any questions about. this checklist, please call the Olpropic Region Clean Air Agency at- (360.).`539.7610 0:
(80~ a~2-5623. / /.~~i~~~~~~ - "~ _ l ~til~~ S~ Y~~'~^7 T
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Aebestas Pctrait
Pcimit # _-.,~ASB00+,..-_.
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Revkw date: ,,,~.J~1J...
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~~"~~ ,.. Reviewed by: ~_ Survey: J Yes [ j No
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