The URL can be used to link to this page

20100211 Permit Pkg 12162010City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Applicant: Name: PROVIDENCE HEALTH SYSTEM Address: 413 LILLY RD NE OLYMPIA WA 98506-5166 Property Information: Site Address: 201 TAHOMA BLVD SE Assessor Parcel No.: 21724130602 Subdivision: Contractor Information: Name: PROVIDENCE HEALTH SYSTEM Address: ROBERT WATILO 413 LILLY RD NE OLYMPIA WA 98506-5166 Contractor License No.: Project Information: Project: COMMERCIAL REMODEL Permit No.: 20100211 Issue Date: 12/16/2010 (Work must be completed within 180 days) Phone: 360-493-7194 Owner: YELM MEDICAL OFFICE BLDG, LLC EAGLE PLAZA Lot: Phone: Expires: 0/00/0000 Description of Work: 2215 SF TI FOR PROVIDENCE HEALTH SYSTEM, 2ND FLOOR Sq. Ft. per floor: Fees: Item FIRE SPRINK Heat Type (Electric, Gas, Other) Contractor ACE FIRE SYSTEMS COMBO-SEE NOTES 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 a of W shin on. lZ-~~/.Zu/~ Signature f Date Firm /-j e` /`i~~ s! `~~s ~ ~-G~ First Second Third Garage Basement Fees $ 160.46 Sets of Prints: nallnspection: Date: sy: Ci t~ of Y~l~ ~ ~ ~0? 4~1~-~40~ F'EC#: 0004861 1~~'16J~01_0 'x:07 Ali L?P'E~: CO TERM: 001 r~'EF#: 10~~ TRAM: 30.0000 RUS[iIES4 LICENSE ACE FIr';E SYSTEM LLC ~JSI~iESS LICE~~SES , ;;,,pOCr, 7F;AN: ;;3.OCi00 F'IJI(_ItIi~t; F'E RM1; f.5 ~0100~11 1~0. ~E~cR F'F;OVIDEMCE }~EAt TH S`. S f IM ~0± TAHDMA BLUR SE FI4f SF';t~'IK 1.60.4~.rR TEP~rEF~ED: .1~~5,46 CHErh: AP`P'LIED: 185.4 f,_. CITY OF YELM COMMERCIAL BUILDING PERMIT APPLICATION FORM • ~J Project Address: ~o~ !D~~lpraa e~/~T~parcel Zoning; Current Use: Proposed New Construction i Re-Model / Re-Roof /Tenant Improvement Plumbing ~ Mechanical i~Fire PrevenUSuppress/Alarm - Other Project Description/Scope of Work: % / ~i'o~ i..P~ n `e % i.r+ -~ J~4i~ Project Value: ~~ oo'- Building Area (sq. ft) Parking Garage 1 g` Floor 2"d Floor / 3~d Floor Building Height Are there any environmentally sensitive areas located on the parcel? _ completed environmental checklist must accompany permit application. BUILDING OWNER/TENANT NAME:11fo g ADDRESS EMAIL CITY STATE ZIP TELEPHONE ARCHITECT/ENGINEER LICENSE # ADDRESS EMAIL CITY STATE ZIP TELEPHONE ~ GENERAL CONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE_CITY LICENSE # CITY If yes, a •v. ~~ EXP r~ U 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. 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 days 105 Ye1m Avenue Weat PO Box 979 Yelm, WA 98597 (360) 458-3835 (360) 458-3744 FAX www.ci.yedm.wa.us d TOWNZEN & ASSOCIATES FIRE 8~ BUILDING CODE SOLUTIONS December 13, 2010 Mr. Gary Carlson Building Official City of Yelm P.O. Box 479 Yelm, WA 98597 RE: Fire Sprinkler Plan Review Providence Time Share-TI Dear Gary: The project listed above is approved for release of the permit; with two red lines or comments noted on the plans. If you have any questions, please give me a call. Sincerely, Townzen 8~ As fates Les Townzen, CFPS President 4944 131 ~' AVE SW 'OLYMPIA, WA 98512 * TEL: 360-754-2335 "FAX: 360-754-7722 www.townzen-consulting.com -~-- ACE FIRE SYSTEMS LLC • Inspection • Testing • Service • Tenant Improvement Brad Weber P.O. Box 2065 Bus: (206} 414-1573 Buckley, WA 98321-2065 Cell: {206) 349-1175 Cont. Reg. N ACEFIFS908M3 Fax: (360) 829-4301 _a~~~~_~ ®~ ~~~a~~o~~aa vRre 12-- ~ - IQ cos no. k7T[NTIOn f ~~( Gn.2L`~«rJ RC p~Ur 7['~Lc TAME: S>~2.~ T_ l . `{CLM t•^Eii~_ off. P.x~ U . To ~~LM _ - 3~0-45~-S~o1 i.ADIE3 / DENTI.EMEN: "^ WE ARE SENDING YOU ~Shi7p drawings D Copy of letter ,~Attsched D Under separate wver Q Prlnts Q Plans ^ ChanSe order [7- the following items: ^ Samples p Specifications ""~_ rr« i nAnSMi i ~ ED gs checked below: ~or approval Q Approved as submitted ^ Resubmit Copies for approval ^ For your use ^ Approved ds noted © Submit ,,.copies for distribution -" DAs reQuested D Returned for corrections d Return Corrected prints D For review and comment ~~_ f~-•Q,N-53- ^ FOR arDS DuE ~p ~p PRINTS RETURNED AFTER LOAN TO USi DG~unve. i i t n . . Contractors or Tradespeople Printer Friendly Page General/Specialty Contractor A business registered as a construction contractor with L&I to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name ACE FIRE SYSTEM LLC UBf No. 603032125 Phone 2064141573 Status Active Address Po Box 2065 License No. ACEFIFS908M3 Suike/Apt. License Type Construction Contractor City Buckley Effective Date 7/23/2010 State WA Expiration Date 7/23/2012 Zip 98321 Suspend Date County Pierce Specialty 1 Fire Protect System Business Type Limited Liability Company Specialty 2 Unused Parent Company Business Owner Information Name Role Effective Date Expiration Date SYTH, BONNIE DENISE Agent 07/23/2010 WEBER, DEBORAH A Partner/Member 07/23/2010 Bond Information Page 1 of 1 Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 1 TRAVELERS CAS is SURETY CO 105380754 07/22!2010 Until Cancelled $6,000.00 07/23/2010 Assignment of Savings Information No records found for the previous 6 year period Insurance Information 125001256-0 107/14/2010 107/14/2011 ~ 1 151,000,000.00107/23/2010 Summons/Complaint Information No unsatisfied complaints on file within prior 6 year period Warrant Information No unsatisfied warrants on file within prior 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 12/14/2010