20150171 Permit Pkg 05062015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: THUNDER FIREWORKS
Address: 5207 - 187TH STREET EAST
TACOMA WA 98446
Property Information:
Site Address: 906 YELM AVE E B
Assessor Parcel No.: 227330110204
Contractor Information:
Name: THUNDER FIREWORKS
Address: JAMES BLAND
5207 - 187TH STREET EAST
TACOMA WA 98446
Contractor License No.:
Permit No.: 20150171! r
Issue Date: 0 /00 /0000
(Work must be C6mpleted within 180 days)
Phone: 253 - 875 -0700
Owner: GREAT WALL PROPERTIES,
LLC
Subdivision: N/A
Phone:
Expires: 0 /00 /0000
Project Information:
Project: FIRE WORKS
Description of Work: FIREWORKS STAND. JUNE 28 THRU JULY 5, 2015
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
FIRE
Contractor
THUNDER FIREWORKS
TOTAL FEES:
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 gover ing zoning and land subdivision, and in addition, all covenants,
easements and restrictions of record. Ka vying as a co�rLractor, I further certify that I am currently
registered in the State of Walton
Signature ' K J� Date
Firm
Lot: N/A
Fees
$ 30.00
$ 30.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Yelm
(36 } 458 -3244
REC #: 00194333 5/06/2015 8:51 AM
OPER: CO TERM: 001
REF #:
PAID BY:
ACCT #: XXXXXXXXXXXXXXXXXXX
AUTH #: 04377Z
TRAM #: 000000001543
IRAN: 33.0000 BUILDING PERMITS
20150171 30.000R
THUNDER FIREWORKS
906 YELM AVE E B
FIRE 30.00CR
TENDERED: 30.00 CREDIT CARD
APPLIED: 30.00-
CHANGE: 0.00
2a�6 rte/
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: 906 Yelm Ave East Parcel #: 22730110204
Zoning; Comercail Current Use: Grocery Store/ Retail Proposed Use: Consumer Fireworks
❑ New Construction ❑ Re -Model / Re -Roof / Tenant Improvement
❑ Plumbing 0 Mechanical 0 Fire Prevent/Stippress /Alarm IZI Other
Project Description /Scope of Work: Retail sales of 1.4 G Consumer Fireworks Class C
Project Value: NA
Building Area (sq. ft) Parking Garage NA 1st Floor lsoo' 2nd Floor na 31d Floor °a
Building Height na
Are there any environmentally sensitive areas located on the parcel? no If yes, a
completed environmental checklist must accompany permit application.
Uil DINS pVyNR11 E(JAlyTr�j/M: Yelm Plaza LLC / Great Wall Propertise Inc.
ADDRESS 16230 East yalleyHtvy. EMAIL NA
CITY Kent STATEwA ZIP aao32 TELEPHONE t•42a9a2 -w49
AR�311T�0INRER NA LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
G t 1 AL GOJJTW."O-T RNA TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
?IU(Ui,BINC .C<7,N7 R\G7`Qf2 NA TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
09ANI0 CQNTRACTOF2 NA TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE. —CITY LICENSE #
Copy of City Mitigation documentation (TFC).
thereby certify that the above Information is correct and that the construction on, and the occupancy and the use of the
above described roparty will be In accordance with the laws, rules and regulations of the State of Washington and the
City of>011 1 /N
App
Owner
to Date
/ Owner's Agent/ Contractor's Agent f Tenant (Please circle one.)
All permits are non - transferable and will expire if work authorized by such permit is not began
within 180 days of issuance, or if work Is suspended or abandoned for a period of 160 days
1061 ehn Avenue WOO (860) 468.8885
PO Box 479 (860) 468- 8144FAX
Whit, WA 98697 nvuuv.0,yehnavams
APPLICATION
FOR RETAIL FIREWORKS STAND PERMIT
TO:
Governing body of city, town, or county in which
DATE OF
3/30/15
fireworks stand will be located.
APPLi(CATION:
_
Applicant Name:.
Address, City, State:
Carla Hitchner
PO Box 298 Mckenna WA 98558
Sponsor (If other than applleant);
Address, City, State:
Saine as above
Same as above
Location of proposed fireworks stand: [EJ nelose draiN ing of stand location]
906 Algyers Drive NE. Yelm WA 98597 (906 Yelln Ave East)
Manner and place of storage prior, during, and after sales dates:
In Stand With Security
State Licensed Fireworks Supplies:
Thunder Fireworks
For The Fireworks Sales Year Of: 2015
(Must be conspicuously displayed at all times while the stand is open to the public)
By virtue of having been granted a Iicense by the State of 1Vashington and this permit from
The City of Yehn as the local governing authority, the named person, firm or
organization is hereby authorized to sell U.N. 0336 1 AG Consumer fireworks at the location designated
herein between the following date and times:
Sales For July 4"! Sales For December 31"
From, Noon June 28th 2015 From:
To: 11:00 PM July 4th 2015 To:
Sponsor: Same as above
/s/
Signature of Official Giwiling PPee�rm /it
Title: Ri.. L.�M.M, Ci / f
Date: V Permit Number:,,
Licensee Name: Carla Hitchner
3OW42"13 (an.a'O)
/s/
Agency:
License Number: WSPFL- 15.0092sn09177
�PgHINGTOM 8r'r
� F
fi
' �ARSH�CS GFF�G�
icensee Data
Washington State Patrol Fire Protection B
Office of the State Fire Marshal
CONSUMER FIREWORKS RETAIL SALES STAN
Thunder Fireworks, Inc.
5207 187th Street East
Tacoma, WA 98446
License Number: WSPFL -00247
Phone Number: (253) 875 -0700
Stand Number: SN -09177
Operational Da
Wholesale7Thun7de
County of Operation: Thurston
Operates For: Carla Hit
Stand Operated By: Carla Hit
THIS PORTION OF THE LICENSE MUST BE POSTED AT THE STAND AT ALL TIMES
E
March 30, 2015
Attention Gary.
City of Yelm
105 Yelm Avenue West
Yelm WA 98597
RE: FIREWORKS PERMIT —1AG CONSUMER FIREWORKS
Dear Gary,
2d5oi-7 (
Please find enclosed a packet submitted to you for the purpose of a Class "C" Fireworks
tent for the 2015- selling period of June 28, 2015 thru July 4, 2015. The information
provided in this packet is for a fireworks tent 1( gated at:
906 Algiers Drive North west Yeh. WA 98597 ( 906 Yelm Ave East.
Parcel # 22730110204
Please confirm receipt of this application oy fax, mail, or email at your earliest
convenience. Once accepted, please direct all permits and or other pertinent information
to Thunder Fireworks, attention James Bland.
If any more information is required please let me know. You can contact me via email, or
phone at 253- 875 -0700 or jamesgthunderfireworks.com.
Sincerely,
James Bland
Thunder Fireworks
APR 0 8 201
5207 -187th Street E., Tacoma, WA 98446 • Phone (253) 875 -0700 • Fax (253) 875 -0550
UVA
March 30, 2015
Attention Bob.
City of Yelm
PO Box 479
Yelm WA 98597
RE: TEMPORARY USE DESCRIPTION
Dear Bob:
We are requesting temporary use of the parking lot at 906 Algiers Drive North West
Yelm WA 98597. (906 Yelm Ave East. Parcel 1# 22730110204. We will be setting up a
40' X 40' tent for the use of class C I AG Consumer Fireworks sales during June 28,
2015 until July 4, 2015. The fireworks to i . � , ill be open to the public starting June 28�"
upon inspection. Operating hours from Junc 29th to July 4t' will be from 9:00 am to 11:00
pm.
There will be electrical usage, such as; cash registers, credit card machines, overhead
lighting. All appliances will be plugged into an outside generator using approved
extension cords.
There will be a minimum of one person on site .7-14 hours a day.
If you have any questions or need any more in:.:.,rmation please call me at 888 -900 -7799.
Thank you for you time.
Sincerely,
� �' ,, " P �W�
James Bland
Thunder Fireworks
253- 875 -0700
james@thunderfireworks.com
5207 - 187th Street E., Tacoma, WA 98446 • Phone (253) 875 -0700 • Fax (253) 875 -0550
l ® DATE (MM /DD /YYYY)
A� o CERTIFICATE OF LIABILITY INSURANCE 3/26/2015
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER NAME: AME: Joanne Manion %rthur J. Gallagher Risk Management Services, Inc. PHONE n/c No
777 108th Ave NE, #200 E -MAIL
3ellevue WA 98004 ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
INSURED THUNFIR -01
Thunder Fireworks, Inc.
5207 187th Street E.
Tacoma, WA 98446
INSURER B:
TYPE OF INSURANCE
INSURER C:
SUBR
WVD
INSURER D:
POLICY EFF
MM /DD/YYYY
INSURER E
LIMITS
INSURER F:
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 15F] OCCUR
rnVFRArFR rFRTIFICATF N11MRFR: rarnrgoF9 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSR
SUBR
WVD
POLICYNUMBER
POLICY EFF
MM /DD/YYYY
POLICY EXP
MMIDDIYYYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 15F] OCCUR
CPP010389801
11/15/2014
1/15/2015
EACH OCCURRENCE
$1,000,000
DAMAGE To RENTED
PREM SES (E. occurrence)
$100,000
ME EXP (Any one person)
$
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO X LOC
PRODUCTS - COMP /OP AGG
$2,000,000
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS NON -OWNED
HIREDAUTOS AUTOS
COMBINED SINULE LIMIT
Ea accident
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
ELP001151001
11/15/2014
1/15/2015
EACH OCCURRENCE
$9,000,000
AGGREGATE
$9,000,000
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER /EXECUTIVE F
OFFICER /MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
WC STATU- OTH-
I TORY LIMITS I
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE -POLICY LIMIT
1 $
1
2
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Location: 906 Algiers Drive NW, Yelm, WA 98597
The City of Yelm and all its employees and Yelm Plaza and all its employees are included as additional insureds but
only as respects the operation of the named insured per policy form CG133F 07/95.
� M ICl/ ATM Ur%1 nOM rAhIrFI I ATInKi
U 1988 -2010 ACORD GUKPUKA I IUN. All rlgnts reservea.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Yelm
ACCORDANCE WITH THE POLICY PROVISIONS.
P. O. Box 479
Yelm WA 98597 USA
AUTHORIZED REPRESENTATIVE
U 1988 -2010 ACORD GUKPUKA I IUN. All rlgnts reservea.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
FIREWORKS TENT LEASE AGREEMENT
THIS LEASE AGREEMENT ( "Lease Agreement "), made this 23rd day of July, between
Yelm Plaza LLC, hereinafter designated the "Land Owner" and Thunder Fireworks, Inc.,
a Washington corporation, hereinafter designated the "Lessee."
WITNESSES: That the said Land Owner does by these presents lease to Lessee the following:
1. PREMISES: 906 Algiers Drive North West, ( 906 Yelm Ave East)
As per the diagram marked Exhibit "A"
2. TERM: June l51" to July I 51 for the year of 2015
3. RENT: _
fir S f
4. SECURITY AND DAMAGE DEPOSIT: Waived.
S.SIJBL.ET: Lessee shall not assign this Lease Agreement or any part hereof without
the prior written consent of Land Owner.
6. LESSEE'S OBLIGATIONS: Lessee shall:
(a) Assume full liability for any and all claims, damages or causes of
action arising during the term of this Lease Agreement caused by Lessee,
it's agents, contractors, sub - contractors, guests and invitees, and hold
Land Owner harmless there from.
(b) Provide Land Owner with evidence of liability insurance effective
for the Tenn in an amount of not less the ten million dollars
($10,000,000.00) with a rider listing Land Owner as a n additional
insured. Lessee will provide documentation to Land Owner showing the
insurance coverage is active prior to the commencement of any use of the
Premises for the term of the Lease.
(c) Properly dispose of all rubbish, garbage and waste generated by
Lessee, its agents, contractors, sub - contractors, guests and invitees, in a
clean and sanitary manner.
(d) Not restrict the flow of traffic (pedestrian / vehicular).
(e) Comply with any and all laws, rules, regulations and requirements
imposed upon it by any governmental agency governing the Lessee's
proposed use of the Premises and post any required performance
bonds with the Iocal government,. Any permits or licenses required
of the undersigned Lessee shall be obtained by the Lessee prior to the
LEASE AGREEMENT — PAGE I
commencement of the Term of this agreement.
(f) Not intentionally or negligently destroy, deface, damage, impair or
Remove any part of the Premises, nor to permit any of it's agents,
contractors, sub - contractors, guests and invitees or other persons acting
under its control to do so.
(g) Suffer no lien to arise or be filcs by any taxing authority or by any
contractor, sub- contractor, or supplier or labor or materials used be
Lessee or any other third party on the Premises; and, in the event any
such lien or claim of lien is filed, cause the same to be satisfied or
discharged in full within thirty (30) days following the filing thereof.
7. USE: Licensee will use the Premises to conduct retail sales of approved
"I AG" or commonly known as Class "C" and/or Consumer Fireworks
along with those activities attendant to that intended use. Lessee may
place temporary striping or cones and a tent as necessary and erect
appropriate signage and will remove the same at the end of the term.
Lessee shall not use the Premises for any illegal purpose. Lessee agrees
to conform to all state, county and municipal codes, statutes, ordinances
and regulations concerning the use and occupation of the Premises and
to obtain the prior receipt of approval of authorities of competent
jurisdiction for its intended use of the Premises with copies thereof to
Land Owner. If the Lessee is unable to procure the necessary firework
permits from the State of Washington, Thurston County or the City of
Yelm to operate a fireworks tent on the above mentioned Premises then
this Lease Agreement shall be null and void.
8. ALTERATIONS: Licensee accepts the Premises in its present conditions, "AS IS, WHERE
9. SURRENDER: At the expiration of said term of this Lease Agreement Lessee will
surrender the Premises to Land Owner in a condition equivalent to or
better that when first made available to Licensee. Reasonable wear and
tear acceptable.
10. ACCESS: Lessee will have unlimited access to the Premises during the term of the
Lease at the entrance / exit shown on the attached Exhibit A.
11. TAXES: Land Owner shall be solely responsible for any taxes on the real
property. Lessee shall be solely responsible for any taxes on its personal
property and/or the conduct of its activities.
12. COSTS. ATTORNEY'S FEES AND VENUE:
If, by reason of any default or breach on the part of either party in the
perfonnance of any of the provisions of this agreement, enforcement of
any term of this Lease is sought, whether or not legal action is instituted,
the losing party agrees to pay all reasonable costs and attorney's fees of
the prevailing party in connection therewith. In the event any claim for
personal injury, death, property damage, or other alleged liability is
asserted against Land Owner arising from Lessee use of Premises during
LEASE AGREEMENT - PAGE 2
13. NOTICES:
14. EXECUTION:
the Term of this Agreement. Lessee agrees to defend and hold Land
Owner harmless of any such claim, including attorney's fees and legal
costs. It is agreed that the venue of any legal action brought under the
terms of this agreement shall be Pierce County, State of Washington.
(a) Notices to Land Owner shall be delivered, personally or by certified
mail, postage prepaid, addressed to Land Owner at:
Yelm Plaza LLC
18230 East Valley Hwy Suite 108
Kent WA 98032
(b) Notices to Licensees shall be delivered, personally or by certified
mail, postage prepaid, addressed to Licensees at:
Thunder Fireworks, Inc
520718711 Street E.
Tacoma, Washington 98446
Phone: 253.875.0700
This instrument is signed in multiple identical copies, any one of which
will suffice for legal purposes as an original.
IN SIGNING THIS INSTUMENT EACH PARTY ACKNOWLEDGES AND
REPRESENTS TO THE OTHER SIGNERS:
(a) That the person signing has read the instrument in its entirety.
(b) That the person signing this document has authority to do so and to
bind his/her principal, understands that this instrument constitutes and
important and binding legal contract, which fixes and determines certain
legal and obligations of the persons signing it.
(c) That no provision of this document can be changes by reference to
any oral representations or agreements.
IN WITNESS WHEREOF, the Lessee and Land Owner have each hereunto signed this
instrument in duplicate the day and year first above written.
LAND OWNER: LESSEE:
THUNDER FIREWORKS, INC
B R By: lames Bland
By: Witness
LEASE AGREEMENT — PAGE 3
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