20140213 Permit Pkg 01222015 CITY OF YELM
COMMERCIA� BUILDING PERMIT APPLICATION FORM
Project Address: �f �� G�rs f l�e�,�,� ��. Parcel#: 7S3LYj y�DO�Dp
Zoning; C �� Current Use: f>aca�-1 Lo� Proposed Use: P_��s�',�.QT�« ��.
� New Construction ❑ Re-Model/Re-Roof/Tenant Improvement
❑ Plumbing ❑ Mechanical ❑ Fire PrevenUSuppress/Alarm ❑ Other
Project Description/Scope of Work: /U " �_ �;f'�. S,�� ��
Project Value: ��2S [�/� .p
--�
Building Area (sq,ft) Parking Garage 1s`FloorZ Z7�2nd Floor 3`d Floor
, �
Building Height �
Are there any environmentally sensitive areas located on the parcel? �I�o_ If yes, a
completed environmental checklist must accompany permit application.
BUtLDING QWN'ER/TEN�NT NAME: S�A�_S'p�
ADDRESS �17`+O rl�,e•u Lq..� �E EMAIL s�.t.G : c�e ro,t .
CITY ac �TATE c q ZIP TELEPHONE
fiRCHITECT/ENGINEER i�( ti; � LICENSE# 9135
ADDRESS 2 � EMAIL .�+,���.,�-<,�Q�K�����.,,�as����
CITY ATE�ZI 9urnz TELEPHO E_ 3�o- 7ot- y7o�
GENERAL CONTRACT�I�r S�o�'f�G{C'o„�c�:o,.� TELEPHONE -�t� -
ADDRESS Pn�3ox ?�`"i EMAIL �o� ,. ;�,,��,,,.�
CITY � STATE Wf ZIP 9(tsv7 FAX 3ier�-N_r9-9-c3i�
CONTRA OR'S LICENSE#Scoth.o��Zl PN EXP DATE�oRS-CITY LICENSE#
PLUMBING CONTRAGTOR '7— � , TELEPHONE 3�D-_S�i)� - yl i3
ADDRESS�'�f3 y .L�n�eLa�r 3 E EMAIL�k., �.,,,� �_.>,�./A�a,,,,� �.tic�
CITY / w ; STATE�l�ZIP ��i FAX --
CONTR T R'S LICENSE#Tunp�Prn�SR9R7 EXP DATES/ CITY LICENSE# tlOR9
MECHANICAL CONTRACTOR�Su„c.-�A:r- TELEPHONE 3GO-4Sle�49t-Y
ADDRESS 5 � c / EMAIL k( .�c�c r,-. �e5,,,,
CITY TATE�_ZIP 9�s-d�z FAX
CONTRAC R'S LICENSE#sc_�tSFA�tZocrt EXP DATE CITY LICENSE# I 3 ^�
Copy of City Mitigation documentation(TFC).
I hereby certify at the above information is correct and that the construction on,and the occupancy and the use of the
above describe property will be in accordance with the laws,rules and regulations of the State of Washington and the
City of Yelm.
2� �'
Appli a re D e
Owner Contractor Owner's Agent/Contractor's Agent/Tenant (Please circle one.)
�e if work authorized by such permit is not begun
� WALL (ONSTRUCTION, IN( �ended or abandoned for a period of 180 days
General Contractor
SfOTTWC121PH
PO Box 2789• Olympia, WA 98501 '��` �'�,��j�
F; (360)459-1051 • FAX (360)459-5313 �sso�4ss���� �015
(.�so)Qs8-
mzow.ci.yelm,ua.us
Scott Wall, President
email:scott@scottwallconstruction.com - -----
____ �
J
T .� ce�
Department of Labor and Industries . ' �' � . `
PO Box 44450 �� �� ,� SCOTT WALL CONSTRUCTION INC
Olympia, WA 98504-4450 � `� �� � `
� � �,�; ��x�� Reg: CC SCOTTWC121PH
� ���'" -� �UBI: 601-092=815
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�'��`� .�w� 3� � _ � � Registered as provided by Law as:
� � �`:�; � ' " , Construction Contractor
;. . � : � ° (CCO 1) - GENERAL
SCOTT WALL CONSTRUCTION �NC � ;� �� Effect�ve Date: 1�0/8/1988
PO BOX 2789 = Expiration Date:'10/13/2015
OLYMPIA WA 98507 � , � �
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