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20130231 Permit Pkg 06122013 � � City of Yelm Permit►vo.: 20130231 Community Development Department �ssue Date: 6/12/2013 ~ (Work must be completed within 180 days) Building Division Phone: (360)458-8407 w«s�».�,q� FaX: (360)458-3144 Applicant: Name: TIMS PHARMACY&GIFTS Phone: Address: P.O. BOX 5120 YELM WA 98597 Property Information: site Address: 106 FIRST ST S Owner: TIM LARSON Assessor Parcel No.: 64400500800 Subdivision: N/A Lot: N/A Contractor Information: Name: ORCA NW Phone: Address: P O BOX 2246 YELM WA 98597 Contractor License No.: ORCANN1964K1 Expires: 5/27/2014 Project Information: Project: COMMERCIAL REMODEL Description of Work: TI Sq. Ft. per floor: First Heat Type (Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor Fees BUILDING ORCA NW $ 209.25 TOTAL FEES: $ 209.25 ApplicanYs Affidavit: I certify that I have read and examined the information contained within the application and know the same OFFICIAL USE ONLY to be true and correct. I also certify that-the proposed structure is in conformity with all applicable City of #Sets of Prints: Yelm regulations including those Gerning zoning and land subdivision,and in addition, all covenants, easements and restrictions ecord. �f applying as a contractor, I further certify that I am currently Final Inspection: registered in the Stat hin ton. l Signature Date " J �— � Date: Firm �Y����I� ,���i�° �'� `�/ �- gy: � Cit� o� Ycl� ;s� >> ��e ��c�x kFl;#� (f+)?;3U(l`.;!� (�,f iZ%1f�1:3 �i;:;f� �iM [1PEli: [;�? i��E�MI�� t)tl l Ftf�f��#� G6�1 TRAh�: :�`.��,�OCJCI t�U1 LD1P�yta PE.f�M 1��1�� 1i�13,1231 2(39.��iC;f� �f�IM�; NFi�1Rh�Ai;Y & G�iI���C�; i0ri F�IR`:��I� ST S Bl l�(;i 1U9."1'`=t(.;ft I kPJ(:iF�REf�� '?lJ�,`l`� C;HE(;I( ,4�a�-:,1..1EG: 2t��,15- __..__._.____.______ C�IANGE� Q,C�D CITY OF YELM C���� �� COMMERCIAL BUILDING PERMIT APPLICATION FORM Pro'ect Address: � 0 � ���S 1 � c1�• S Parcel#: Zoning; Current Use:�l,�,r�,.�ar;.//;:�'cProposed Use: - New Construction =' Re-Model/Re-Roof/Tenant Improvement Plumbing � Mechanical .� Fire Prevent/Suppress/Alarm � Other Project Description/Scope of Work: ( �N e�.,.-F % �,,,,,��^,,� „� w f Project Value: ��� C� �� Building Area(sq.ft) Parking Garage 1 S�Fioor 2"d Floor 3�d Floor Building Height ro " Are there any environmentally sensitive areas located on the parcel? l VA If yes, a completed environmental checklist must accompany permit application. BUILDING OWNEWTENANT NAME: ADDRESS EMAIL CITY STATE ZIP TELEPHONE ARCHITECT/ENGENEER LICENSE# ADDRESS EMAIL CITY STATE ZIP TELEPHONE GENERAL CONTRACTOR � - o c� • S �TELEPHONE O �- 7 - �- tl �/ ADDRESS �O. !jo Z EMAIL G�� ctJ ��,.,,, t� .;,, o � C��' STATE (N ZIP `��S 5 7 FAX CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE# PLUMBING CONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE# MECHANICAL CONTRACTOR TELEPHONE ADDRESS EMAIL C��1' STATE ZIP FAX CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE# Copy of City Mitigation documentation(TFC). 1 hereby certify that the above information is correct and that the construction on,and the occupancy and the use of the above described perty will be in accordance with the laws,rules and regulations of the State of Washington and the City of Yelm=' Applicant's S� ature 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 Yelm Avenue West (360)458-3835 PO Box 479 (360)458-3144 FAX Yelm,WA 98597 www.ci.yel _ ��X�r��_ 1 �uN � 2 Zo�3 � RY� { Q W � 9 � ° � � N M< ,y �'� >K . _ _._._____ � ___ -� ------ - , - -- ___ � �:, _. '�K. �K ^ ,`' , ', -�'--�--- �� ,,,y, C. � � � �� �( .� �.�__._______ -._____ _._�__.. -��\ J 1 ` � ,` � � _ � T � � � . . 1 Md ".k, i � � � � r' � -a + � • � 1 �. „�7. ' � i � " ;, � _ �._ - -- 8 � ' N c � ' i 3 >�� � � '"'� l � r � � j � '' / � � �`� i .- , , _ .� • \ ,.r � � � � ; � : � / _.�___._�..__._ .......,_ . � _-- - ----- — j ------ _ � , � . � �, � `.,. / � ' , . , - --- i\ ��� ___---- � ' �� : I� � ' , ' � I ( � �� .. 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