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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 ...~...~. t.A1T.r.T ~ nm/~T r . rL__i.:c _ ....<, r,«mn~ infnrmatinn JJLrlYlVL1t1V1V 4V1VtMVtVl\ ~,.irwnsaorau~.ao •.. Business Namc: ..-• ~+•-----•••----- --- Phone: fl - Email: bG tn.lcr FAX: /Lt~+eberp~NOJ/~vRa2.Dq/. Onsite Contact: Phone: illobile: ( ) ~f!-ND (/vE8E1'Z.. FAX: Mailing .address: S ~ c A'VM' S City: ~~~, - -- Stat~~ Zi~ 3 D 2_ of Structures present 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. ~ultltfNGfoN ~dp~d.t... ~/ ~ t3 ~ Applit;ant Name Signature Date ~- ,~-, d) Datc~l~gTicattonilt~cce~it~e Payment Info: [~ Approved tlsbcstos Permit ` [ ]Cash [ ]Disapproved Permit # AS$00 ~EC ~ 200 ]Check: # ~y'L° ~ ~- ~ d cc 7 / ~ [ date:~/ R i Demolition Permit Permit # ~ ~ DER-I00~~ ] Credit Car ~ ev etv y gg ~^ /;~ +~+ ~ ~ Receive date:l~ /~/! ~ Reviewed by: ~ ~ ..~1'r B lfe~~il' ~ enc Ure Oar! A e~t~ Ure O~~ !1 err Ure O1rl~ 10/21!08 UV b;lt ~.2/2.1/~,010 08:44 FA% 425 251 8782 BARGHAUSEN ENGINBERS 2940 8 Limited lane NW Olympa. WA 98502 Phone: (360) 539.7610 FAX: (360) 491.6308 wwa+.orcaa.arg Training Fire Request ~ ooz/ooz APPLICANT NAME/TTI'Ll:: WasttingtOr Federal Savl-ti9ttIWflAam Gletut, VP Spedal Assets Oepl .'-PPLICANT /FIRE PROTECTION AGENCY: ~ of Yelrn Flre Dept APPLICAN'I'ADDRE$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 /._... ~ / .. ~ _ - ~e 3 Date - v i te~q~' anon/rt-~i:~a ~~ ~ 'V E± ~ i --•- FettnicRequinements p~ Approved I J D~PP~'ed Aebestas Pctrait Pcimit # _-.,~ASB00+,..-_. t DEC ~ ~ 20th ~v ~.at' ~vrn ~(UG~(l~~ ~~~~ ~, II Revkw date: ,,,~.J~1J... / ' Demolition Pcralit Yeasth #~EM00 ~9 . bvr~' Io~~- . d date;..-/~ .~ FAX -, ~ ~~"~~ ,.. Reviewed by: ~_ Survey: J Yes [ j No ItViu24:Uxrldal-letson.Dorumen~euvukrdocr.TniningFre.doe-Cira~edoo5/t5/D6f0:06AhtbYSeaeRyboit ~~ (~,-o'~~-iCS =' f y ~ t 'a---