BLD-05-0099
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CITY OF YELM - BUILDING DEPARTMENT
CERTIFICATE OF OCCUPANCY
Building Address 1202 Yelm Ave. E. Ste C Fire Zone
Occupancy Group B
Owner Name Forbest Partners Use Zone C-1
Owner Address P.O, Box 12540 Type of Construction V-B
Olympia. WA 98508
Building Permit Number BLD-05-0099- YL Plan Number
Has been inspected and the following occupancy thereof is hereby authorized
Area under Maximum Maximum Allowable
Floors Occupancies This Certificate Occupant Floor Loads
Sauare Feet Load Lbs per SQ Ft.
1 B 2594 26
Remarks
Areas Inspected
Special Conditions
Is Building Sprinklered?
YES
X NO
Building Official
Gary Carlson
Date
Julv 20, 2005
POSTING The Certificate of Occupancy shall be posted in a conspicuous place
on the premises and shall not be removed except by the Building Official
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0099-YL
Issue Date 04/07/2005
(Work must be started within 180 days)
Receipt No
36102
Applicant:
Name
Forbest Partners
Phone:
360-352-2004
Address P.O Box 12540
City' Olympia
State: WA Zip 98508
Property Information:
Site Address 1202 Yelm Ave. E, Ste. C
Assessor Parcel No. 22730110103
Subdivision. N/A
Lot: N/A
Contractor Information.
Name. PBJ Contracting, Inc.
Contact: Berchaurer, Patrick
Phone. 754-5788
Address. P.O Box 11489
City' Olympia
State WA Zip 98508
'""__"'___,__ I _____ "1_ ..._ 1__.............,.
.....Vl HI Q....lVI ~1....'C;II,;)C;; I'lliV. r ,,",""'''VI I uvnu
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Project Information
Project: John L Scott TI
Description of Work: 2594 Square foot TI
Sq Ft. per floor' (1st) 2594
(2nd) 0
(3rd) 0
Garage 0
Basement 0
Heat Type (Electric, Gas Other): GAS
Fees.
Item Item Fee Base Amt Unit Fee Unit Rate No Units Unit Desc
--------------------------- -------------
Building Permit - Other 594 46 000 000 o 0000 o 0000 $1 000
Building Plan Review 386 40 0.00 000 o 0000 o 0000
Plumbing Permit 3400 2000 1400 7 0000 2.0000 Fixture
Sewer ERU 1083400 000 1083400 54170000 2.0000 ERU
Sewer Inspection 290 00 0.00 290 00 1450000 2 0000 ERU
Sewer Deposit 100 00 5000 000 o 0000 o 0000
Water Meter (Commercial) 300 00 300.00 000 o 0000 o 0000
Water ERU 3 000 00 000 3 000 00 1.500 0000 2.0000 ERU
Water Deposit 80 QO 4000 000 o 0000 o 0000
Traffic Facilities Charge 7 117 50 000 7,11750 7500000 9 4900 Peak PM Trip
State Building Fee 450 450 000 0.0000 o 0000
TOTAL FEES $22,740.86
Applicant's Affadavit:
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 governing zoning and land subdivision, and in addition. all covenants
easements and restrictions of record, If applying as a contractor I futher certify that I am currently
registered in the State of Washington
OFFICIAL USE ONLY
# Sets of Prints.
Signature
7h:~,
~-
0, Q/ -:;;J/'-'
Date
'-/- 7- C?
By'
Firm
.__. - - .--
~TH~~ CITY OF
I~Y '\~I YELM
~ PO Box 479
Yelm, WA 98597
.,.:rE!:-.M,.o. 360-458-8403
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RECEIPT No 36101
RE.,.Ci=NJ:;RlN THOUSAND NINE HUNDRED TWENTY FIVE DOLI,ARS & 10 CENTS
RECEIVED FROM
FORBEST PARTNERS LLC
P.O BOX 12540
OLYMPIA, WA 98508
DATE REC NO
04/107/105 361101
AMOUNT
110.925 110 CHECK
REF NO
5170
SITE 12102 YELM AVE E aTE B
MISCELLANEOUS RECEIPT
GRETCHEN
BLD PER 231 58. PLN REV 1510 52. PLM 34, SEW ERU 5417, SEW INS 145, CONS DEP90
WAT MET 300,WAT ERU 15100, TRAP 31052 50. ST BLD FEE 4.50
-~ -- -~- ~-~~---'- ~--~--~-~._~---- -- ~- -- ~- -~ ~
.=-____~__i _____________._____.__________._.__ ___ _____________
RECEIPT No. 36102
R~i=J.~ENTY TWO THOUSAND SEVEN HUNDRED FORTY DOLLARS & 86 CENTS
RECEIVED FROM
FORBEST PARTNERS LLC
P O. BOX 12540
OLYMPIA. WA 98508-
SITE 1202 YELM AVE E STE C
DATE REC. NO
04/07/105 361102
AMOUNT
22.740 86 CHECK
REF NO
5171
I
i
\..
MISCELLANEOUS RECEIPT
GRETCliEN
./
BLD PER 594 46. PLN REV 38~ 40, PLM 34, SEW ERU 10834. SEW INS 290.
WAT MET 3000. WAT ERU 80, TRAF 7117 50 Sf BLD FEE 4 50
CONSDEP90
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Permit Fees Schedule
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: Forbest Partners
Address. P.O Box 12540
Project Information:
Project: John L Scott TI
Description of Work: 2594 Square foot TI
Site Address. 1202 Yelm Ave. E, Ste. C
Fees.
Item Acct Code
Building Permit - Other
032001-322-10-00
Building Plan Review
100001-345-83-00
Plumbing Permit
032001-322-10-00
Sewer ERU
802412-343-50-01
Sewer Inspection
805412-343-80-00
Sewer Deposit
742402-389-01-00
Water Meter
(Commercial)
712 401-843-80-01
712401-343-80-01
Water ERU
740402-389-00-00
Water Deposit
420 120-344-85-00
Traffic Facilities Charge
160001-386-00-00
State Building Fee
TOTAL FEES.
Permit No BLD-05-0099-YL
Phone:
360-352-2004
City' Olympia
State. WA Zip 98508
Assessor Parcel No. 22730110103
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
------------...
594 46 000 0.00 0.0000 o 0000 $1,000
386 40 000 000 o 0000 o 0000
3400 20.00 1400 7 0000 2.0000 Fixture
10,83400 000 10,83400 5.417 0000 2.0000 ERU
290.00 0.00 290 00 1450000 2.0000 ERU
10000 5000 000 0.0000 o 0000
300.00 300.00 000 o 0000 0.0000
3,000 00 000 3,00000 1.500 0000 2,0000 ERU
80.00 4000 000 o 0000 0.0000
7,11750 0.00 7,117.50 750.0000 9 4900 Peak PM Trip
450 4,50 000 0.0000 o 0000
$22,740.86
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Page 1 of 1
From Gary Carlson
Sent: Wednesday, March 30, 2005 10"30 AM
To Jim Gibson, Tami Merriman
Subject: DQ Building
fI
Tami Merriman
Jim & Tami,
I need eru's and TFC's for Mike McKinnon's building 2580 sf will be for John L Scott and 1106 sf will be for an
unnamed Mortgage Company
My Occupancy numbers are 25 for JLS and 5 for the Mortgage Company I checked with Janine and JLS now
shares a meter with Pizza Hut and Subway
Mike would like the permit yesterday
Gary
~bo+h U~ 6 lo~ MW ~\"~
I'
--T-FG ~~ ~'7J 120 \to
d5~O C1,
-
/ I O~ LA ,D l ~ ~ lOCO? ,5W
.----.
3/30/2005
03/30/2005 15 08
3609435154
n CITY OF YELM (\
COMtt._.~CtAL BUILDING PERMIT APPLICA TIOt\.-.-.JRM
Project Address jXOQ e~"'" r~ hV6 parcel#'~7~31J- 110 \OS
Zoning, c.- \ Currant Use $'1"'tlf> ~A-Il. PropoSedUse.~tArre (!- pAyOrT'I' WJ..N
~t.L''-E' Ci 0 - ~e,. L-€5rl'l r~
U New Construction AS- Re-Modell R&-Roof enant 1m rovement (j p. FIt if..
u Plumbing U Mechanical U Fire Preventl uppress/A arm U Other
Project Description/Scope of Work: /ASS.-r"LL. ~11.1"'r, (/~t..(".RJ T=-- fl'llf. 4.9J1...IAj ~ ~ /:J.. DIJf~I()P)~
Project Value _~ I;,(f:~ I 't ~-I 2-D
Building Area (sQ 1\) Parking Garage I 1st Floor~ Floor
Building Height C,.f!ILJlf.U. IHJ" I~ 'f _It) 1+. II f)~ / ll:1'1
}lO.
PAGE
01/01
'---~/
3/0 Floor_
Are there any environmentally sensitive areas located on the parcel?
completed environmental checklist must accompany permit application
If yes, a
BUILDING OWNERlTENANT NAME. Foeee.J:....,. /?9~/I~U -UiC--
ADDRESS ~1~ ~() ..N~J( /tA5<fO EMAIL m'K...~ (j,1I rfJ OtP...t!.1-W>
CITY bL"'1'11 /I) STATE J1)A- liP 9~(j8 TELEPHONE ~..5.::L-Q..OOq
ARCH ITECTIENGI NEER
ADDRESS
CITY
~A
STATE
ZIP
LICENSE #
EMAIL
TELEPHONE
,
"-----
GENERAl. CONTRACTOR ~e7lN'~, TELEPHONE 7.r -
ADDRESS-f~.. SO'/' EMAIL ..
CITY 01--'1' STATE WI ZIP 50' FAX
CONTRACTOR'S LICENSE #,C~~t.../~a.t> EXP DATE CITY LICENSE #e~/$TI"'(
TELEPHONE 7~"'- ~t.ltr
EMAIL
CITY LICENSE # ~)f.Js r / "" ,
MECHANICAL CONTRACTOR ..sUN~~ r ,.,I/?"'" TELEPHONE rS~- t.f 9$
ADDREss5.L1IJ /''''L!B: Y Bt..fA? EMAIL
CliY STATE ZIP 9'tfG'-J FAX
CONTRACTOR'S LICENSE bi-NS-E4.;..2ttJtIllEXP DATE CITY LICENSE # -C)(IA"'/~G
Copy of City Mitigation documentation (TFC).
I hereby certify thpt thA abllVG Information I. correct and thRt tha CGnllltructlon on, IInd the occupancy and the u.e of the
above doscrtbed pruperty will be I... aCCOrdl!lnCA with the lews, rule. and mgulatlons of the State of WilIllhlnfrl.OtI and the
City of Yalm.
7!l.td-J /;/?JL-,,< ~
pp icant's Signature
Owner I Contractor I Owner's Agent I Contractor's Agent I Tenant
:3~3lJ-oS
Date
(Please circle one)
All permits are non-transferable and will expire If work authorized by 8uch permit is not begun
within 180 days of Issuance, or If work Is suspended or abandoned for a period of 180 days
"-----/
105 Yelm Av~n.,e Wes'
PO &n= .(19
Yelm. WA 98697
(360) 4SB-;J8J5
(a60) 468-8144 FAX
www.d.yelm.wB.wt