20100196 Permit Pkg 02012011City of Yelm Permit No 20100196
Community Development Department Issue Dale: 2101/2011
(Work must ba ~vmp72ted within t80 days]
Building Division
Phone: (360)458-8407
Fax: (360)458-3144
Applicant
Name: Apple Physical Therapy Phone: 2538406448
Address: 2904 4th Ave NE #300
Puyallup WA 98372
Property Information:
site Address: 201 TAHOMA BLVD Owner. APPLE PHYSICAL THERAPY
Assessor Parcel No.: 217424130602 Subdivision: Lot:
Contractor Information:
Name: SUNSET BUILDERS Phone:
Address: FRANK
3108 C STREET SE
AUBURN WA 98002
Contractor License No., SUNSEBI140LS Expires: __1!1312011
Projectlnformadon:
Project: COMMERCIAL REMODEL
Description of Work: 3652 SF TI FOR APPLE PHYSICAL THERAPY FIRE ALARM
Sq. FL per floor: Heat Type (Electric, Gas, Other): COMBO-SEE NOTES
First
Second 3652
Third
Garage
Basement
Fees:
Item Contractor Fees
FIRE ALARM PIONEER FIRE ANO SECURITY $ 160.46
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Applicant's Affidavk: OFFICIAL USE ONLY
I certAy that I have read and examined the information contained within the application and know the same
to bP Vae and correct t also certify that the proposed structure is in conformity with all applicable City of # Seh nt Prints
Yelm regulations including those governing zoning aM Wntl subdivision, and in addition, all covenants,
easements and restrictions of record If applying as a contractor, I further certify that I am currently Final Inspection:
registered in a S
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CITY OF YELM
[] COMMERCIAL BUII.L`DING PERMIT APPLICATION FORM
Project Address: -1 ~ ~ y Q~ Y1A ~~Q. W ~ ~, I , Parcel #: ~L(~ 2~ 130(~17U
Zoning; Current Use: Proposed Use:
n New Construction I I Re-Model I Re-Roof 1 Tenant Improvement
u Plumbing C Mechanical 5C Fire Prevent)Suppress larm Other
Project Description?Scope of Work: ~~ rG ~}~ (Yl
Building Area (sq. R) Parking Garage 1" Floor 2n° Floor3~~3"' Floor
Building Height
Are there any environmentally sensitive areas located on the parcel? __ If yes, a
completed environmental checklist must accompany permit application.
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
~f(ij~~ LICENSE #
ADDRESS _~_ EMAIL
CITY_ STATE ZIP TELEPHONE
e jnr~L!
Ef~,:i•'COt~Ii•f~,1Gji3 PiDneCY Fi'rCrSe~urFiELEPHONE:31,0-~1-g191
ADDF2FS5 PO 5°rI ~N1AIL io e ~'cbyv~GGS-I•ltet
CITY E ~11?~ its STATEJ~_ZIP~ FAX 3l?t~- 1- 55
CONTRACT T'Q SfT LICENSE #'ProNcF391~3LCEXP DATE CITY LICENSE #p0 ~~5. t
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P$.~i`i~9L1j~:~AC3;OR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
tvjECHAtJ1EAk;~Opy~k%~}'f,~t TELEPHONE
ADDRESS ____ EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S L.ICFNSE # EXP DATE CITY LICENSE #
Copy o} Ciry Mitigation documentation (TFC).
I hereby eerily that the abovo Information is correct and Mat the construction an, and the occupancy and Me use of the
above described property will be In accordance with iha laws, rules and regulations o}the State of Washington and the
Cit~y/off Yclm.
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Applicanfs~5ignat Date
Owner (Contractor /Owner's Agent /Contractor's Agent /Tenant (Please circle one.)
All permits are non-transferable and will expire ff 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
705 5'elm Auenru Weet (360) 468-3835
YO ftos 479 (360) 468-3144 NA%
Yefm, WA 9R697 ramm.Ci.yafrn.mn.us