20160358 Permit Pkg 11042016City 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: Q/1R V=l M AvC C o
Assessor Parcel No.: 227330110204 Subdivision
Contractor Information:
Name: THUNDER FIREWORKS
Address: JAMES BLAND
5207 - 187TH STREET EAST
TACOMA WA 98446
Contractor License No.:
N/A
Permit No.: 20160358
Issue Date: 11/04/2016
(Work must be completed within 180 days)
Phone: 253 - 875 -0700
Owner: YELM PLAZA LLC
Phone:
Expires: 0 /00 /0000
Lot: N/A
Project Information:
Project: FIRE WORKS
Description of Work: RETAIL SALES OF 1.4 G CONSUMER FIREWORKS CLASS C. DEC 29 THRU DEC 31, 2016
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 cor[pcL I also- that the proposed structure is in conformity with all applicable City of
Yelm re to—ns including those -governing zoning and land subdivision, and in addition, all covenants,
ease ents nd restrictions of record. lit applying as a contractor, I further certify that I am currently
registered i the tate of Washington.
Signature
,� v"Date
Firm
Fees
$ 35.00
$ 35.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of Mm
(36 i) 458 -3244
RECA': 00248709 11/04/2016 12:48 PM
OPER: CO TERM: 001
REFS': 7456
PAID BY:
TRAM: 33.0000 BUILDING PERMI13
20160358 35.0(CR
THUNDER FIREWORKS
906 YELM AVE E B
FIRE 35.0(CR
1E , NDERED : 35.00 CHECK
APPLIED: 35.00-
CHANGE: 0.00
APPLICATION
FOR RETAIL FIREWORKS STAND PERMIT
TO:
Governing body of city, town, or county in which
DATE✓ OF
Fireworks stand will be located.
APPLICATION:
Applicant Name:
Address, City, State:
Carla Hitchner
PO Box 298 Mckenna WA 98558
Sponsor (If other than at }ulleantl:
Address, City, State:
Location of proposed flreworlts stand: [Enclose drawing of stand location]
906 Algyers Drive NE. Yelm WA 98597 (906 Yelm Ave East)
Manner and place of storage prior, during, and after gales dates:
In Stand With Security
State Licensed Fireworks Sttpplier•
Thunder Fireworks, Inc.
FIREWORKS STAND PERMIT
For The Fireworks Sales Year Of: 2016
(Must be conspicuously displayed at all times while the stand is open to the public)
By virtue of having been granted a license by the State of Washington and this permit front
The City of Yelm as the local governing authority, the natned person, firm or
organization is hereby authorized to sell U.N. 0336 JAG Consumer fireworks at the location designated
herein between the following date and times:
Sales For July 01 Sales For December 31"
From: Prom: December 29, 2016
To: To: December 31, 2016
Sponsor:
Location 906 Algyers Drive NE. Yeltn WA 9$597 (9U6 Yelm Ave East
/s/
Granting Pennit
Applicant
�� L
Title: t� � T1.1(t Agency:
Date: ll • LI• jl.P Permit Number: �1�O�e
Licensee Name: Hitehner License Number: wsPFI. 002d7/ 16.0129
3000420•on (Rev. D'OS(
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: 906 Yelm Ave East Parcel #: 22730110244
Zoning; Comercail Current Use: Grocery Store/ Retail Proposed Use: Consumer Fireworks
❑ New Construction ❑ Re -Model / Re -Roof / Tenant Improvement
❑ Plumbing 4 Mechanical
❑ Fire Prevent /Suppress /Alarm ❑✓ 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 N/A 1 °t Floor 600' 2nd Floor wA 3rd F1oorNIA
Building Height N/A
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 Plaza LLC / Great waii Properiise Inc.
ADDRESS 18230 East Valley Hwy. EMAIL NA
CITY scent STATE wA 71P aensq TI+I t= ounntr:
ARCHITECT /ENGINEER NA LICENSE #
ADDRESS EMAIL
CITY STATE ZIP
GENERAL CONTRACTOR NA TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE_CITY LICENSE #
PLUMBING CONTRACTOR NA TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE_CITY LICENSE #
MECHANICAL CONTRACTOR NA TELEPHONE
ADDRESS EMAIL
CITY STATE Zip FAX
CONTRACTOR'S LICENSE # EXP DATE Cl 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 or the
above described property will be In accordance with the laws, rules and regulations of the State of Washington and the
city of otm.
Applicant's Signature Date
Owner/ Contractor/ 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
105 I eIrn Auen tie Weat (360) 458.8835
PD Bas 979 (360) 458 -3144 FAX
Yelm, lYA 88597 rotaa.cl.yelrn. Iva. rrs
October 30, 2016
City of Yelm
105 Yelm Avenue West
Yelm WA 98597
RE: FIREWORKS PERMIT —1AG CONSUMER FIREWORKS
City of Yelm,
Please see the enclosed application for the purpose of the retail sale of consumer
fireworks. The sales are planned to commence on December 29, 2016 — December 31,
2016. The structure will be in an 8'x 20' metal trailer. The proposed selling site is located
at 906 Algiers Drive NW, Yelm, WA 98597 on parcel # 22730110204
Please confirm receipt of this application by fax, mail, or email at your earliest
convenience. Once accepted, please direct all permits and or other pertinent information
to Thunder Fireworks, attention Brandy Bargelt.
If any more information is required, please let me know. You can contact me via email,
or phone at 253- 875 -0700 or brandy @thunderfireworks.com
Sincerely,
1
Brandy Bargelt
Director of Operations
5207 187th Street East, Tacoma, Washington 98446
Phone 253.875.0700 • Toll Free 888.900.7799 • Fax 253.875.0550 - www.thunderfireworks.com
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,�►coR °® CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD /YYYY)
1 3/1/2016
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 CONTACT Joanne Manion
Arthur J. Gallagher Risk Management Services, Inc. PHONE 425-454 -3386 FAX 425 451 -3716
777 108th Ave NE, #200 E -MAIL
Bellevue WA 98004 ADDRESS:
T.
INSURED TH U N FI R -01
Thunder Fireworks, Inc.
5207 187th Street E.
Tacoma, WA 98446
(a11%1=10 A(_CC !`COTICI!`ATM r.l"RAMM n. 11AOf)AR900
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTVVITHSTANDING 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
IN D
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE LX] OCCUR
CPP010389802
11115/2015
11/15/2016
EACH OCCURRENCE
$1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
$100,000
MED EXP (Any one person)
$Excluded
PERSONAL & ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY D PRO -
JECT LOC
GENERAL AGGREGATE
$Not Applicable
PRODUCTS - COMP/OP AGG
$2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE I
Ea accident
$
ANY AUTO
BODILY INJURY (Per person)
$
AUTOS ED SCHEDULED
BODILY INJURY (Per accident)
$
HIREDAUTOS AUTOS NON-OWNED
AUTOS
(PROPERTY -DAMAGE
Per accident)
$
A
UMBRELLA LIAB
X
OCCUR
ELP001151002
11/15/2015
11/15/2016
EACH OCCURRENCE
$9,000,000
X
EXCESS LIAB
CLAIMS -MADE
AGGREGATE
$9,000,000
DED I X I RETENTION $0
$
WORKERS COMPENSATION
PER OTH-
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER /EXECUTIVE ❑
OFFICERIMEMBER EXCLUDED?
NIA
STATUTE ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
$
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E. L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 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.
IUtStli-zu14 AL:UKU UORPURATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Yelm
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
P. O. Box 479
Yelm WA 98597 USA
AUTHORIZED REPRESENTATIVE
IUtStli-zu14 AL:UKU UORPURATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
FIREWORKS TENT LEASE AGREEMENT
THIS LEASE AGREEMENT ( "Lease Agreement "), made this 18th day of November
2015, between Yeln( 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: December 29`h — December 31" the year of 2016
3. RENT:
4. SECURITY AND DAMAGE DEPOSIT: Waived.
5.SUBLET: 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 Term in an amount of not less the ten million dollars
($10,000,000.00) with a rider listing Land Owner as an 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 local government.. Any permits or licenses required of the
LEASE AGREEMENT — PAGE 1
undersigned Lessee shall be obtained by the Lessee prior to the
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 files 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
IS, and with ALL FAULTS." Lessee agrees not to make alterations to
the Premises without the prior written consent of the Land Owner.
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
performance 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
LEASE AGREEMENT — PAGE 2
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
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.
13. NOTICES: (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
5207 187`h Street E.
Tacoma, Washington 98446
Phone: 253.875.0700
14. EXECUTION: 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:
Y�
By: Witness
LEASE AGREEMENT — PAGE 3
LESSEE:
THUNDER FIREWORKS, INC
By: James Bland
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