20050070
CITY OF YELM INSPECTION LOG
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PROJECT
'Jf;'L~ ~Y'-'-" MJle-C l-~
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PERMIT NUMBER
(f3' S-~ bOt 0
ADDRESS
iftJL-- ~ \l.Rv ~
FOOTING
o 12"
o 16"
o other
o requIred vents
WALL
o 6"
o 8"
o other
SET BACKS Date
Front
Rear
Slde'Flank.mg
SIde
FOOTI~G REBAR
Date
W.\LL REBAR
Date
Comments
C01\lBIl\ED FRAME/ EXTERIOR SHEAR WALL INSPECTIO~
Hold downs
Frame
Plumbmg
o Shear Nallmg 0
[] Gas/Propane u
~ So &1 ' ok.. Jft 3-05' Mechanical 0
./\
'v Comments
I~Sl1LA nON
u Gas
o Foam and Seal
o Electric
~ Vapor barner
Q Other
[J PV-\
Comments
SHEET ROCK/SHEAR \V .\LL NAIL
Comments
OTHER
Comments
FINAL
o Sewer Final
o Address
[J Electncal
o InsulatIOn
o CI\ 11 Fmal
o Slle Dramage
o Landscape F mal
o SIdewalk
o coro
Comments Jv s puJ~
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Permit No
BLD-05-0070- YL
Issue Date. 03/09/2005
(Work must be started within 180 days)
Receipt No
35838
Applicant:
Name: Jeff Marshall
Phone:
446-4949
Address. P.O Box 769
City' Rainier
State. WA Zip 98576
Property Information:
Site Address. 202 Cullens
Assessor Parcel No. 21724241200
Subdivision: N/A
Lot: N/A
Contractor Information:
Name: Jeff Marshall
Contact:
Phone: 446-4949
Address. P.O Box 769
City' Rainier
State. WA Zip. 98576
Contractor License No: BLUEFC'016C4
Expires. 07/17/05198
Business License:
Project Information:
Project: Yelm Family Medicine T.I
Description of Work: Tenant Improvement of old Theraputic Associates wing
Sq. Ft. per floor' (1 st) 0
(2nd) 0
(3rd) 0
Garage 0
Basement 0
Heat Type (Electric, Gas, Other)
Fees:
Item
Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
-------------
888.75 643.75 245.00 7 0000 35.0000 $1,000
577 68 0.00 000 0.0000 0.0000
53.25 0.00 0.00 0.0000 0.0000
3400 20.00 1400 7 0000 2.0000 Fixture
$1,553.68
Building Permit 5o-1ook
Building Plan Review
Mechanical Permit
Plumbing Permit
TOTAL FEES
Applic,ant's, Aff~d~vit:
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 zoni and land subdivision and in addition, all covenants,
easements and s of record. If a R as a contractor, I futher certify that I am currently
registere e Sta g
OFFICIAL USE ONLY
# Sets of Prints:
Date
Final Inspection:
Signat
By'
Firm
o
o
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit Fees Schedule
Permit No BLD-05-0070-YL
Applicant:
Name. Jeff Marshall
Phone.
446-4949
Address. P O. Box 769
City' Rainier
State. WA Zip 98576
Project Information:
Project: Yelm Family Medicine T.I
Description of Work: Tenant Improvement of old Theraputic Associates wing
Site Address. 202 Cullens Assessor Parcel No 21724241200
Fees.
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No Units Unit Desc
--------------------------- -------------- -------------
Building Permit 5o-1ook 032001-322-10-00 888 75 643 75 245.00 7 0000 35 0000 $1 000
Building Plan Review 100 001-345-83-00 577 68 000 000 o 0000 o 0000
Mechanical Permit 032 001-322-10-00 53.25 000 000 o 0000 o 0000
Plumbing Permit 032001-322-10-00 3400 2000 1400 7 0000 2.0000 Fixture
TOTAL FEES $1,553.68
o . II . I G
RECEIPT No 35838
RECEIVED
****ONE THOUSAND FIVE HUNDRED FIFTY THREE DOLLARS & 68 CENTS
RECEIVED FROM
JEFF MARSHALL
POBOX 769
RAINIER WA 98576
BLD 05 0070 YL
SITE 202 CULLENS
DATE
PEC NO
AMOUNT
1,553 68 CHECK
REF NO
03/09/05 35838
5075
MISCELLANEOUS RECEIPT
MICHELLE
./
BLD PRMT 888 75, BLD PLN REV, 577 68 MECH 53.25, PL PRMT 34 00
o
o
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
Permit Fees Schedule
Permit No BLD-05-0070-YL
Applicant:
Name: Jeff Marshall
Phone:
446-4949
Address. POBox 769
City' Rainier
State: WA Zip 98576
Project Information:
Project: Yelm Family Medicine T.I
Description of Work: Tenant Improvement of old Theraputic Associates wing
Site Address. 202 Cullens Assessor Parcel No. 21724241200
Fees.
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
--------------------------- -------------- -------------
Building Permit 50-10ok 032001-322-10-00 888.75 643 75 245.00 7 0000 35.0000 $1,000
Building Plan Review 100001-345-83-00 577 68 000 000 0.0000 o 0000
Mechanical Permit 032001-322-10-00 53.25 000 0.00 o 0000 o 0000
Plumbing Permit 032001-322-10-00 3400 2000 1400 7 0000 2.0000 Fixture
TOTAL FEES $1,553.68
o
o
March 6, 2005
Plan Review comments for Yelm Familv Medicine Clinic.
1) Exam 1, 2, and 3 shall be marked as accessible Exam 4-8 cannot be as drawn.
The return wall at the stnke Jamb IS not long enough to meet HC standards. 18"
2) No medIcal gasses are allowed m the cltmc
3) Place an eXIt sIgn outsIde exam 3 dIrectmg people down the hall to the eXIt.
4) The anchor bolts at the pool fill m must be 3" from the bottom of the ledger 16"
o.c. max.
5) ProvIde a max 3/8" threshold heH!ht at all ext doors
6) HC restrooms bust be constructed to the Washmgton State standards for reach,
clearance and fixtures.
7) Suspended acoustIcal ceIlmg systems shall be mstalled m accordance
WIth the proVISIons of ASTM C 635 and ASTM C 636
All changes can be made dunng constructIOn. The plans are stamped approved.
Joseph Butler
..
c
o
c
,------... CITY OF YELM ~
C00ERClAL BUILDING PERMIT APPLlCA10 FORM
Project Address. 80'9.l!UGL~ B...o ,. - Parcel #. -
Zoning, -K-:'0 Current Use'- C / Y Proposed Use' (~*"'"
U New Construction pRe-Model/ Re-Roof / Tenant Improvement
U Plumbing U Mechanical U Fire Prevent/Suppress/Alarm U Other
Project Description/Scope of Work: ~ 8'~>'\ ~()).A.~ 0'.A:S'l' W~
Project Value. g~ OtJD
Building Area (sq ft) Parking Garage 1st Floor 3( Dg 2nd Floor 3rd Floor_
Building Height dd-
Are there any environmentally sensitive areas located on the parcel? A..) 0 If yes, a
completed environmental checklist must accompany permit application.
II\.
u.t2--
BUILDING OWNJ~R/T;:NANT ~AME.
ADDRESS &f)C:J- CilUen-1S
CITY Y:t:u#\ STATE{))1'r
ARCHITECT/ENGINEER" p-,. ::r::-L.--r-
ADDRESS
CITY STATE ZIP
EMAIL
TELEPHONE {.15'FS -77103
LICENSE #
EMAIL
TELEPHONE
. Ii Prf!G~ TELEPHONE Lfc-f6 ~ 'f
'~ ~~IL -r~~~~ C( t{.~4C0~
EXP DA T8d-t'4' CITY LICENSE #
PLUMBING CONTRACTOR
ADDRESS
CITY STATE
CONTRACTOR'S LICENSE #
TELEPHONE
EMAIL
FAX
EXP DATE CITY LICENSE #
TELEPHONE l.f..?& r~' '5
EMAIL
zIPq~~7 FAX
E)tp DATE CITY LICENSE #
ZIP
MECHANICAL CONTRACTOR
ADDR~S
CITY . e:1A\I\.. STATE u..J.A:.
CONTRACTOR'S 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 nce with the laws, rules and regulations of the State of Washington and the
Cit
~-.1ef5
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
Received
FEB 1 0 Z005
105 Yelm Avenue West
PO Box 479
Yelm, WA 98597
(360) 458-3835
(360) 458-3144 FAX
www.ci.yelm.wa.us
Thurston Geodata Center - Parcel Search
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Data for Parcel No. 21724141200
Zoom Map to Parcel
Owner'
Address:
City'
State
View Assessor's Data for Parcel
ELLEDGE-MUCHMORE PARTNERSHIP
PO BOX 760
YELM
WA, 98597
Parcel No
Site Address.
Site City
Site Zip
21724141200
202 CULLENS ST NW
YELM
98597
Section
Legal Description
s24171 E
24-17-1 E SE-NE COM X NEL Y LN JEFFERSON
ST & NW LY LN SOLBER G 1ST N
65 - SRV-PROFSNAL
170
Yes
SRV
097
$170,20000
$873,700 00
$1,043,90000
N
None
Usecode
Tax Code Area.
Taxable
Property Type
Total Acres.
Land Value.
Building Value
Total Value
Current Use
Exemptions
Wetlands
Floodzone
Flood of 1999'
Winter Flooding of 1996
High Groundwater Flood Hazards.
Unknown
NO
Unknown
Unknown
Unknown
Zoning
Historic Site
Permitting Jurisdiction
Jurisdiction of Influence
Stormwater Rate
No Shooting Zone
Animal Control
R-6,
No
YELM
YELM
No
No
Contact Animal Control (360-458-3244)
http.//geomap 1 geodata.org/websltel cadastrallresultsparce1.asp ?parcel =21724141200
3/8/2005
Thurston Geodata Center - Parcel Search
o
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Page 2 of2
Weed Containment Zone
Steep Slopes.
Ground Water Sensitive Areas.
DNR Natural Heritage Data.
Critical Buffers:
Shoreline Management Areas'
Waterbody & Wetland Buffers.
FEMA Panel No
No
Unknown
No
Unknown
No
No
No
355
Wellhead Protection Area.
Area of Groundwater Concern
Elevated Nitrates.
Soil Type
Hydric Soil
Watershed
Water Service Area.
School District:
Elementary School:
Middle School
High Schoool
Fire Response District:
Medic Response District:
Residential Outdoor Burning
Planning Region
Census Tract:
Radio or Cell Tower
No
No
No
Spanaway gravelly sandy loam, 0 to 3% slopes
No
NISQUALL Y RIVER
YELM, CITY OF
YELM
SOUTHWORTH
MILL POND AND YELM
YELM
YELM
Medic 2
Residential Outdoor Burning is banned within the
city limits and urban growth areas of Lacey,
Olympia, and Tumwater
2
012410
No
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3/8/2005
Look Up a Contractor, Electnclan or Plumber LIcense DetaIl
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Topic Index I Contact Info
'v~--~"-~--'r'---------~-------_.'''---'- ":11'- .,
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ii General/Specialty Contractor
A business registered as a construction contractor with L&I to perform construction work within the scope
of its specialty A General or Specialty construction Contractor must maintain a surety bond or assignment
of account and carry general liability insurance
Ii..-...... ..
License Information
License BLUEFC'016C4
Licensee Name BLUE FEATHER CORP
Licensee Type CONSTRUCTION CONTRACTOR
UBI 601921686 Verify Workers Comp Premium
Stat.us
Ind. Ins. Account
Id
Business Type CORPORATION
Address 1 PO BOX 769
Address 2
City RAINIER
County THURSTON
State WA
Zip 985760769
Phone 3608943485
Status ACTIVE
Specialty 1 GENERAL
Specialty 2 UNUSED
Effective Date 2/24/1999
Expiration Date 7/17/2005
Suspend Date
Separation Date
Parent Company
Previous License JEFFMC'099PM
Next License
Associated
License
_._-- _.--J
rBu;iness Owner Information
I II
,
-'_....,-~
Iii
https.l/fortress. wa.gov/lmlbbIp/DetaIl.aspx?LIcense=BL UEFC*O 16C4
3/8/2005
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Name Role Effective Date Expiration Date
MARSHALL, JEFF 01/01/1980
.. ......".. I FLEUR L 01/01/1980
Bond Information
Bond Bond
Company Account Effective Expiration Cancel Impaired Bond Received
Bond Name Number Date Date Date Date Amount Date
Until
#4 CBIC SE6451 06/26/2003 Cancelled $12,00000 06/25/2003
WESTERN Until
#3 SURETY CO 69273331 02/02/2002 Cancelled 04/05/2004 $12,00000 02/14/2002
DEVELOPERS
SURETY a Until
#2 INDEM CO 521696C 12/29/2000 Cancelled 03/24/2002 $6,000 00 08/02/2001
DEVELOPERS
#1 INS CO 521696C 02/01/1999 12/29/2000 $6,000 00
'S~VingS Information ,----.----, .' ., i1
! No Matching Inf~mation -~~~~__.__~,._._~JI
"'"
Insurance Information
Company Policy Effective Expiration Cancel Impaired Received
Insurance Name Number Date Date Date Date Amount Date
#5 CBIC INSSE6451 06/26/2003 06/26/2005 $1,500,00000 OS/21/2004
#4 CBIC INNSE6451 06/26/2003 06/26/2004 $3,000,000 00 06/25/2003
WESTERN
HERITAGE
#3 INS CO SCP0626021 06/26/2002 06/26/2003 06/26/2003 $300,000 00 07/15/2002
FARMERS
TRUCK INS
#2 EXCHANGE 602409509 OS/21/1999 OS/21/2002 05/14/2001
TRUCK INS
#1 EXCHANGE 600897645 11/05/1998 11/05/1999
~ ...,..."'..--,-.....---..--.....--""f'
~ Summons / Complaints Information I,
~ No Matching Information Ii
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Thurston Geodata Center - Parcel Search
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Thurstonc,~'~\
."'.<<, ""
GeoDa'~ . ,
eente' .,
, .1 ~
Owner'
Address.
City'
State.
o
Data for Parcel No. 22730140300
Zoom Map to Parcel
View Assessor's Data for Parcel
LEFEBVRE, LEO A
PO BOX 1056
YELM
WA, 98597
Parcel No
Site Address.
Site City'
Site Zip
Section
Legal Description
Usecode
Tax Code Area.
Taxable
Property Type
Total Acres
Land Value
Building Value
Total Value
Current Use
Exemptions.
22730140300
10533 SR 507 SE
YELM
98597
s30172E
30-17-2E PTN SE NE COM 276 5F N OF CEN
SE NE S 54-56-0E 62 LESS ROW SR507 JCT
SR510 TO BALD HILLS RD VIC 3418622
15 - MOBILE-HOME-PARK
170
Yes
LDG
376
$108,30000
$131,50000
$239,800 00
N
None
Wetlands.
Floodzone
Flood of 1999'
Winter Flooding of 1996
High Groundwater Flood Hazards:
Zoning
Historic Site
Permitting Jurisdiction
Jurisdiction of Influence
Stormwater Rate
No Shooting Zone
Animal Control.
Unknown
NO
Unknown
Unknown
Unknown
C-1,
No
YELM
YELM
No
No
Contact Animal Control (360-458-3244)
http.//geomap 1 geodata.org/webslte/ cadastral/resultsparce1.asp ?parcel =22730140300
Page 1 of2
3/4/2005
Thurston Geodata Center - Parcel Search
o
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Page 2 of2
Weed Containment Zone
Steep Slopes.
Ground Water Sensitive Areas
DNR Natural Heritage Data.
Critical Buffers.
Shoreline Management Areas.
Waterbody & Wetland Buffers:
FEMA Panel No
No
Unknown
No
Unknown
No
No
No
365
Wellhead Protection Area
Area of Groundwater Concern
Elevated Nitrates.
Soil Type.
Hydric Soil
Watershed
Water Service Area.
School District:
Elementary School:
Middle School
High Schoool
Fire Response District:
Medic Response District:
Residential Outdoor Burning
Planning Region
Census Tract:
Radio or Cell Tower
No
No
No
Spanaway gravelly sandy loam, 0 to 3% slopes
No
NISQUALL Y RIVER
YELM, CITY OF
YELM
FORT STEVENS
MILL POND + YELM MID
YELM
YELM
Medic 2
Residential Outdoor Burning is banned within the
city limits and urban growth areas of Lacey,
Olympia, and Tumwater
2
012410
No
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3/4/2005