20160134 Permit Pkg Fire 04142016City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: RICK CHRISTENSEN
Address: 11915 CLEAR LAKE RD
EATONVILLE WA 98328
Property Information:
Site Address: 16605 106TH AVE SE
Assessor Parcel No.: 643034nn�.,;nq
Contractor Information:
Name: RICK CHRISTENSEN
Address:
11915 CLEAR LAKE RD
EATONVILLE WA 98328
Contractor License No.:
Project Information:
Project: COMMERCIAL REMODEL
Description of Work: 3503 RESTAURANT TI
Sa. Ft. Der floor-
First
Second
Third
Garage
Basement
Fees:
3503
Subdivision:
Permit No.: 20160134
Issue Date: 4/14/2016
(Work must be completed within 180 days)
Phone:
Owner: RICK CHRISTFNSFni
Phone:
Expires: 0 /00 /0000
Heat Type (Electric, Gas, Other): HEAT PUMP
Lot:
Item
Contractor
BUILDING
RICK CHRISTENSEN
Fees
FIRE
RICK CHRISTENSEN - 4/26/2016
$57,550.84
MECHANICAL
SUNSET AIR INC
$ 160.46
PLUMBING
AFFORDABLE PLUMBING
$ 75.00
FIRE ALARM
ALARM CENTER
$ 132.00
FIRE SPRINK
KNIGHT FIRE
$ 183.56
$ 878.87
TOTAL FEES:
$ 58,980.73
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 governing zoning and land subdivision, and in addition, all covenants,
easements and restrictions of record. If applying as a contractor, I further certify that I am currently
registered in the State of Washi ton.
Signature Date l
/ 2112 —
Firm
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Ci�j of Feli
(36 ) 458-3244
REC#: 00229540 4/26/2016
'PER: CO TERM, 001 1:21 PM
REF#: 1206
PAID By:
IRAN: 33,0000 BUILDING PERMITS
20160134 160.46CR
CHRISTENSEN, RIOX
FIRE 16605 106TH AVE SE
160-46CR
TRAM: 30.0000 BUSINESS LICENSE
NB FIRE & SAFETY NW
BUSINESS LICENSES & 35-OOCR
TENDERED.- 195-46 CHECK
APPLIED: 195.46 -
CHANGE: ---- -0
.00
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: 16605 106th Ave.SE Parcel #:
Zoning; Current Use: Proposed Use: ReStaLLant
j( New Construction C Re -Model 1 Re -Roof / Tenant Improvement
Plumbing t -I Mechanical IX Fire Prevent(Suppress /Alarm ❑ Other
Project Description /Scope of worts: installation of UL #300 fire system in restaurant hood
Project Value: $3200.00
Building Area (sq. ft) Parking Garage 15` Floor 2ntl Floor P Floor
Building Height
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER/TENANT NAME: C;hrisensen Mariarhi
ADDRESS 16605 106th Ave. SE EMAIL
CITY Yelm STATE /A ZIP g���TELEPHONE
ARCHITECT/ENGINEER LICENSE #
+ ADDRESS EMAIL
CITY STATE _ ZIP TELEPHONE
GENERAL CONTRACTOR Sunset Air TELEPHONE 360 456 -4956
ADDRESS EMAIL
CITY Lacey S ATE WA ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
PLUMBING CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR Fire & Safety NW TELEPHONE 800 7as -7124
ADDRESS 241 Mox Chehalis Rd. EMAIL _tnmaffcnw VRhnn� rnm
CITY Elma STATE ZIP gA5 1 FAX
CONTRACTOR'S LICENSE # FIRESN *066L11 XP DATEMYj$TY 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.
f ,
Tom Leavitt ' 4 -14 -16
Applicant's Signat e, Date
Owner I Contractor I Owner's ent 1 Contractor gent I 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
105 Yelm Ave W (360) 458 -3835
(360) 458 -3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us