TI ApplicationStirrett
Johnsen
Tn C
May 7, 2010
City of Yelm
105 Yelm Avenue West
Yelm, WA 98597
Attn: Gary Carlson
mechanical contractors
5555 WESTGATE RP. NW.• SILVERDALE,WA 98383 • ST-IR-RJ '28186
(360) 69.^.-6128 FACSIMILE (360) 698.7832
RE: Yelm Medical Office Building -Tenant Improvements 1s` floor
SJI Job Number 203
Dear Gary:
Attached are 5 sets of drawings, a completed permit application and a copy of our Yelm
business license. Please issue a plumbing permit for the T.I. on the first floor. Contact me at
the above phone number when the permit is ready and we will send someone to your office with
a check to pick it up.
Sincerely,
/~ /
Diane Almojuela
Contracts
attachments
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CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: 911 Yelm Ave East Parcel #: zn2atsosoo, znzatsosoo, 2t7zatsoso2
Zoning; C-1 Current Use: Vacant Bldg. Proposed Use: 'B' -Business
New Construction ~Re-Model / Re-Roof /Tenant Improvement
Plumbing ^ Mechanical ^ Fire PrevenUSuppress/Alarm D Other
Project Description/Scope of Work: Tenant Improvements for new building - 1st floor
Project Value: $166 , 000
Building Area (sq. ft) Parking Garage. NA 1s` Floor 17.456 2nd Floor 15.900 3rd Floor~_
Building Height 35'-0"
Are there any environmentally sensitive areas located on the parcel? no If yes, a
completed environmental checklist must accompany permit application.
BUILDING,OVJNERITENJyNT NAME: Yelm Medical Offce Building LLC (Contact Scott Ritter)
ADDRESS 2840 Crites Street West Suite 104 EMAIL scottlritter(o~comcast.net
CITY Tumwater STATE,yg_ZIP 98512 TELEPHONE (3601 292-7850 /ext 1211
ARCHITECT/ENGINEER TGB Architects LICENSE # 3626 (L. Kent Greeory)
ADDRESS 21911 76th Ave W Suite 210 EMAIL gdais@tgbarchitects.com
CITY Edmondc STATE~y~ZIP 98026 TELEPHONE 4251778-1530
GENERAL CONTRACTOR Aldrich & Asso iat TELEPHONE (425) 483-1313 '
ADDRESS_$10 240th Str t EMAIL chaltermanfg aldrich-a_cc~com,
CITY Bothell STATE WA ZIP 98021 FAX_ (425) 486-1018
CONTRACTOR'S LICENSE # 22301 EXP DATEzISn tCITY LICENSE # 09-000050 0
ryUmttlNC~ ~N I FiACTOR Stirretf Johnsen TELEPHONE (3601 692-6128
ADDRESS 5555 Westgate Road NW EMAIL rtarper(a~sjimech.com
CITY Silverdale STATE wA ZIP.. 98383 FAX 1360) 698-1832
CONTRACTOR'S LICENSE #_ STIRRJ*281B6t EXP DATES/lO~ITY LICENSE #_10-002660.0
~ MECHgNICAL CONTRACTOR Evergreen RefrigerationTELEPHONE (206) 763-1744
ADDRESS 727 South Kenyon Street EMAIL richard@evergreenhvac.com
CITY Seattle STATE_yyg_ZIP 98108 FAX (206) 763-2389
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 [he
City of Yelm.
pr
Applicant's Signature
Owner / Contractor I Owner's Ag~rtt I Contractor's Agent /Tenant
5/7/10
Date
(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 Yeim Avenue West (860) 458-3835
PO Bos 479 (3G0) 458-3144 ~ ~} S'j C2 S-15~~
Yelm, WA 98597 www.ci.ye[m.w s r-~ tCSS VV 115
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YEAR ~~'~
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NOT VALID UNTIL FEE IS PAID
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IS HEREB'f LICENSED TO OPERATE
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This license must be posted in a conspicuous place at the business location
LICENSE
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