20100215 Permit Pkg 11172010City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: FORBEST PARTNERS
Address: P.O. BOX 12540
OLYMPIA WA 98508
Property Information:
Site Address: 1202 YELM AVE E C
Assessor Parcel No.: 22730110103 Subdivision:
Contractor Information:
Name: BAILEY GENERAL CONTRACTOR
Address:
8270 28TH COURT NE
LACEY WA 98516
Contractor License No.: BAILEGC968KE
Permit No.: 20100215
Issue Date: 11/17/2010
(Work must be completed within 180 days)
Phone: 352-2004
Owner: FORBEST PARTNERS
Lot: NIA
Phone: 360-9154
Expires: 5/06/2012
Project Information:
Project: COMMERCIAL REMODEL
Description of Work: APPROX 1386 SO FT TI, REDUCING THE FORMER JOHN L SCOTT OFFICE
Sq. Ft. per floor: First
Second
Third
Garage
Basement
Fees:
Item
BUILDING
1386 Heat Type (Electric, Gas, Other): COMBO-SEE NOTES
Contractor
BAILEY GENERAL CONTRACTOR
TOTAL FEES:
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 restrictions of record. If applying as a contractor, I further certify that I am currently
registered in the State of ngton. /
Signature% /~ Date! ~` f7 ' ~Z
Firm
Fees
$ 645.56
E 645.56
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
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CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: ~ Zd Z -1~.1'N r>'v~ G Parcel #: ZZ~ 30 (t O (b ?
Zoning; G ( Current Use: ~`-~ ~ Proposed Use: ~~
-New Construction ~(; Re-Model / Re-Roo Tenant Improvement
Plumbing -. Mechanical -Fire Preven u arm -Other
Project Description/Scope of Work:_ ~i NoR- ~-FM~IOAEt. >~r~ IVEW OA~G~"
Project Value:_ 2~ ~~
Building Area (sq. ft) Parking Garage 1" Floor i 3~ 2"d Floor 3ro Floor
Building Height !~
BUILDING O ER/TENANT NAME: Wt11Clr It~i:14aNNoN
ADDRESS D EMAIL Ltd • t~.r.
CITY STATE -~ ZIP TELEPHONE 2
Are there any environmentally sensitive areas located on the parcel? _~ If yes, a
completed environmental checklist must accompany permit application.
ARCHITECT/ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR TELEPHONE o G
ADDRESS_~2T(~ Zf~ cwtT N 2c~1 EMAIL G^ C.G.. G,o~
CITY l.~kG~LI STATE wf~ZIP~~_FAX
CONTRACTOR'S LICENSE # XP DATE LICENSE # O
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).
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 laws, rules and regulations of the State of Washington and the
City of Yelm.
'~ Q
Applican ' Date
Own Contract / Owrfer's Age /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
p ~G~B~~
Pry'! 1..'. 2ij1
105 Yelm Avenue
PO Box 479
Yelm, WA 98597
B Y:
(360) 458-3835
(360) 458-3144 FAX
www.ci.yelm.wa.ua