20150117 Fire App 08052015CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: 10520 Creek St SE Yelm, WA. Parcel #:
Zoning; Current Use, Proposed Use:
New Construction Re -Model Re -Roof / Tenant Improvement
Plumbing Mechanical Fire Prevent/Suppress /Alarm Other
Project Description /Scope of Work: Install Fire Sprinkler System
Project Value: $91,500.00
Building Area (sq. ft) Parking Garage 1" Floor 2nd Floor 3`d Floor
Building Height
Are there any environmentally sensitive areas located on the parcel? no If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER/TENANT NAME: Yelm Creek Apartments, LLC
ADDRESS 240 S. Stadium Way EMAIL
CITY Tacoma STATE WA- ZIP 98402 TELEPHONE 253-428-080
ARCHITECT /ENGINEER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR Berg Residential TELEPHONE 253 -428 -0800
ADDRESS 240 S Stadium Way EMAIL tracyhipnr @sebberg.com
CITY Tacoma STATE WA. ZIP 98402 FAX 253- 428 -8172
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 425 - 583 -47775
ADDRESS PO Box 1457 EMAIL shelley @umifireprotection.com
CITY Marysville STATE WA. ZIP 98270 FAX 360 - 435 -4802
CONTRACTOR'S LICENSE # UNLIMM1093M6 EXP DATE 5- 16CITY 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 accordance with the laws, rules and regulations of the State of Washington and the
City of Yelm.
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Applicant's Si at a Date
Owner / Contracto 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
AUG 0
(360) 458 -3835
105 Yelm Ave W (360) 458 -3144 FAX
Yelm, WA 98597 www.ci.velm.wa.us'