20170105 Permit Pkg 01182017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: SAFEWAY, INC
Address: P.O. BOX 85001 98015 -8501
BELLEVUE WA 98005
Property Information:
Site Address: 1109 YELM AVE E
Assessor Parcel No.: 85810000100
Contractor Information:
Name: SAFEWAY, INC
Address: SHARON BREDESON
P.O. BOX 85001 98015 -8501
BELLEVUE WA 98005
Contractor License No
Permit No.: 20170105
Issue Date: 1/18/2017
(Work must be completed within 180 days)
Phone: 206 - 455 -6530
Owner: SAFEWAY INC.
Subdivision: N/A Lot: N/A
Phone:
Expires: 0 /00 /0000
Project Information:
Project: COMMERCIAL REMODEL
Description of Work: REMODEL STARBUCKS KIOSK
Sq. Ft. per floor: Heat Type ype (Electric, Gas, Other):
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 overning zoning and land subdivision, and in addition, all covenants,
easements restr ions -re:--q . If applying as a contractor, I further certify that I am currently
registere in the State f W shin n.
Signature
Date "l
Firm ` G —�J (r�/ (COI J -STYDZir;; tA— 7 t 1
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Second
Third
Garage
Basement
Fees:
Item
Contractor
BUILDING
SAFEWAY, INC
Fees
PLUMBING
SAFEWAY, INC
$ 1,470.93
$ 27.00
TOTAL FEES:
$ 1,497.93
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 overning zoning and land subdivision, and in addition, all covenants,
easements restr ions -re:--q . If applying as a contractor, I further certify that I am currently
registere in the State f W shin n.
Signature
Date "l
Firm ` G —�J (r�/ (COI J -STYDZir;; tA— 7 t 1
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Clt�f of felm
(361) 458 -3244
REC #: 00256416 111812017 10:32 AM
OPER: CO TERM; 001
REF #: 11857
PAID BY:
TRAN: 33.0000 BUILDING PERMIT'S
20170105 1,497.91CR
SAFEWAY, INC
1109 YELM AVE E
I 1, 470.9 CR
PL L 27.0CCR
TENDERED: 1,497.93 CHECK
APPLIED: 1,497,93 -
CHANGE: 0.00
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: 1109 E Yelm Ave, Yelm WA 98597 Parcel -#- e5 8(OC)bC1) J pC)
Zoning;
Current Use: Safeway Grocery Store Proposed Use:
❑ New Construction x Re -Model / Re -Roof / Tenant Improvement
❑ Plumbing Mechanical Fire Prevent/Suppress /Alarm Other
Project Description /Scope of Work: Replacement of existing Starbucks kiosk with a new larger version of Starbucks kiosk
Project Value: $85,000
Building Area (sq. ft) Parking Garage 1St Floor 250 sf 2 d Floor 3rd Floor
Building Height
Are there any environmentally sensitive areas located on the parcel? N/A If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNER/TENANT NAME: Safeway Inc.
ADDRESS 1371 OAKLAND BLVD STE 200 EMAIL ioe.ianus cDsafewav com
CITY Walnut Creek STATE CA ZIP TELEPHONE 425- 201 -6411
ARCH ITECT /ENGINEER_ PM Design Group Inc. LICENSE #
ADDRESS 19401 40th Ave West, Suite 300 EMAIL dwallace @pmdginc.com
CITY Lynnwood STATE WA ZIP 98036 TELEPHONE 425- 405 -7747
GENERAL CONTRACTOR Tricon Commercial Construction TELEPHONE 206 - 310 -8771
ADDRESS 405 Baker Blvd Suite B EMAIL gregr @tc- const.com
CITY Tukwila STATE WA ZIP 98188 FAX 253 - 246 -7110
CONTRACTOR'S LICENSE # CC TRICOCC881JO EXP DATE ? /21/18CITY LICENSE # 603 194 606
PLUMBING CONTRACTOR Advanced Plumbing TELEPHONE 509- 453 -5055
ADDRESS 141 N. Kershaw Dr. EMAIL advancedplumbing1 @gmail.com
CITY Yakima STATE WA ZIP 98908 FAX 509 - 453 -5025
CONTRACTOR'S LICENSE # *ADVANP1940BP EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR NSA TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY 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 r f_yrrk .
Sighatu
er /Contractor / Owner's Agent / Contractor's
d 2�l
_ Date
enant (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 11a t s�
D L� V
t'AAN 0 l
105 Yelm Ave W
(360) 458 -3144 FAX
Yelm, WA 98597 www.ci.yelm.wa.us
CITY OF YELM
COMMERCIAL BUILDING
NON - STRUCTURAL PLAN REVIEW
CORRECTION LIST
BASED ON 2015 INTERNATIONAL BUILDING CODE
PERMIT #
DATE:
PROJECT NAME:
PROJECT ADDRESS:
PARCEL#:
OWNER:
ARCHITECT:
CONTRACTOR:
PLANS REVIEWER:
VALUATION OF WORK:
TYPE OF CONTRUCTION:
OCCUPANCY GROUP:
20160105
January 10, 2017
Starbucks Kiosk installation
1109 Yelm Ave E
85810000100
Safeway, Inc
PM Design Group Inc
Tricon Commercial Construction
Ron Kemp
$85,000.00
VA
M/B
PROVIDE THE APPROVED SET OF PLANS, AND BUILDING PERMIT
CARD AT TIME OF INSPECTION.
BUILDING REVIEW COMMENTS:
Plans are approved with the following notes:
1. Provide annual inspection for the building reduced pressure backflow assembly.
2. Prior to installation of GW -20 Great Basin grease trap provide details on installation.
3. GW -20 Great Basin grease trap must be maintained at the manufactures level of
recommendation and it must be installed with an air gap.
GENERAL NOTES:
1. All contractors, subcontractors or other concerns doing business related to this project shall
obtain a City of Yelm business license prior to beginning work. Applications for this license
are available at Yelm City Hall.
2. Any deviations from the approved plans and specifications shall be submitted in writing and
approved by the Building Safety Official before the change is made. Note: Any changes in
the approved plans may require additional plan review fees to be paid.
3. All work shall remain accessible and exposed for inspection until approved by the Building
and Fire Safety Official. Any work covered prior to inspection and approval shall be made
accessible for inspection.
Page 1 of 2
4. It is the responsibility of the person doing the work authorized by a permit to notify the
Building and Fire Safety Official that such work is ready for inspection. Request for
inspection shall be made in writing, or may be called in (360- 458 -8410) by the applicant at
least 24 hours in advance.
5. When calling for final inspection, you must have obtained the following approval(s) prior to
requesting final building inspection.
A. State electrical
B. Yelm Public Works for grease trap (sewer)
When the above approvals have been obtained, a final inspection by the Building Safety
Division may be requested.
6. Electrical Inspection service is not provided by the City of Yelm Community Development
Department. Electrical permits and inspections shall be obtained by contacting the
Washington State Department of Labor and Industries, Electrical Inspection Division.
Electrical inspections required to be signed off prior to calling for City of Yelm inspection are
as follows:
A. Prior to frame inspection.
B. Prior to final inspection.
These sheets are a part of the plans and shall remain attached thereto. The approval
of plans and specifications does not permit the violation of any section of the
International Codes or other City ordinances or state law.
I have read the information herein, and agree to the revisions stated in the "review
comments" section written above.
January 11, 2017
Plans Reviewed by: Date
Signature of owner /applicant
Page 2 of 2
Date
COUNTY COMMISSIONERS
John (Hutch) Hutchings
District One
Gary Edwards
District Two
Bud Blake
District Three
THURSTON COUNTY PUBLIC HEALTH AND
SOCIAL SERVICES DEPARTMENT
SINCE 1852
Art Starry Interim
Director
Rachel C. Wood, MD, MPH
Health Officer
January 10, 2017
Greg Roybal, Design Coordinator
Tricon Commercial Construction
405 Baker Blvd
Tukwila, WA 98188
RE: CONDITIONAL APPROVAL STARBUCKS REMODEL AT SAFEWAY (folder #11- 108346)
Dear Mr. Roybal:
Our department has received and reviewed your plans for the above - referenced food establishment
located inside Safeway #1619 at 1109 E Yelm Ave, Yelm, WA. The scope of the project basically
involves demolishing the older kiosk and replacing it with a new one with the addition of a warming oven
and replacing certain equipment. Based on the information provided, the plans are hereby approved.
This approval is with a list of conditions that follow and shall be addressed prior to re- opening the food
establishment:
1. During any demolition and/or construction, provide protection (plastic barriers) to prevent dust,
debris, and material from contaminating food and equipment around the vicinity inside Safeway.
2. All building, planning, fire and electrical code requirements must be completed and passed with
final inspection prior to scheduling for a pre - opening inspection with the health department.
3. The lighting shall offer the correct amount of foot candles over the food preparation areas. With
the additional equipment added (i.e. oven), make sure adequate lighting is added to this new area
of the kiosk as we have discussed this with the last several Starbuck (Safeway) remodels in West
Olympia and Lacey projects.
4. All openings around utilities and conduit passing through walls, floors, and ceilings must be
sealed.
5. Follow plumbing plan as per sheet P2.0 with all equipment requiring an indirect connection
having a floor sink or hub drain.
6. Per the plan, most refrigeration equipment and other equipment will be replaced like for like.
7. All hand -wash sinks must be provided with soap and paper towels (and dispensers). Hot and
cold water, under pressure, must be available at all times at hand -wash sinks and three -
compartment sinks.
8. A sign to notify food workers to wash their hands must be posted at each hand wash sink.
9. All refrigeration units must have visible working thermometers.
412 Lilly Rd. N.E., Olympia, Washington 98506.5132
(960) 867 -2500 FAX (360) 867.2600 TDD (360) 867.2603 TDD (800) 658.6384
www, co, th urston. wa. us/he alth
Starbuck at Safeway #1619 (Yelm)
January 10, 2017
Page Two
10. Employees shall be provided with an approved area to store their personnel belongings rather
than on top of food products and/or single- service items (i.e. cups, lids, etc.). This will be
verified during the pre - opening inspection.
11. You must pay for your annual food establishment permit and any accrued plan review /pre-
opening inspection fees before you will be given permission to reopen your establishment.
Allow for at least one business day after your final pre - opening inspection for us to finalize your
bill and process the permit. You may make payment in person, over the phone with a credit/debit
card, or send a check through the mail. Payments must be received by this office before
approval will be given for you to open your facility.
12. Any additional expansion of menu, addition or change of equipment, or remodel of the
establishment requires review by this Department.
13. This letter and the establishment file reflect items discussed during plan review. You will be
responsible for meeting all requirements of Article H, Rules and Regulations of the Thurston
County Board of Health Governing Food Service and the Washington State Retail Food Code
Chapter 246 -215 Washington Administrative Code. If you do not have a copy of this
information, please contact our office.
14. All other conditions previously established by this office regarding the operation of this food
service facility shall remain in effect.
15. Our records indicate that your establishment is in the following billing category with the
corresponding square footage for each category. If our records are incorrect, please let us know.
Category Square footage
Low Risk 600
16. A pre - opening inspection must be scheduled and conducted prior to reopening for business.
Upon addressing and/or acknowledging the above - mentioned items, you may contact my office to
schedule for a pre- opening inspection. Upon request, we can provide a pre - opening check sheet to assist
and prepare your food establishment for the pre - opening inspection. If there are any changes or
modifications to the plans prior to the pre - opening inspection, please notify my office immediately to
discuss or arrange for meeting onsite to assess the change(s). For any other questions or to schedule a
pre- opening, contact my office at 360 - 867 -2572.
S
J Caird, REHS; CP -FS
Technical Lead/Plans Examiner
Environmental Health Specialist H
Thurston County Public Health and Social Services
cc: City of Yelm Building Department, 105 W Yelm Ave, Yelm, WA 98597
412 Lilly Rd. N.E., Olympia, Washington 98506 -5132
(360) 867 -2500 FAX (360) 867 -2600 TDD (360) 867 -2603 TDD (800) 658 -6384
www.co.thurston.wa.us/hea1th
THtA,p
City of Yelm
�0*
9
Community Development Department
d
M
Building Division
YELM
Phone:(360)458-8407
Fax: (360) 458 -3144
Applicant:
Name: SAFEWAY, INC
Address: PO BOX 85001 98015 -8501
BELLEVUE WA 98005
Property Information:
Site Address: 1109 YELM AVE E
Assessor Parcel No.: 85810000100 Subdivision:
Contractor Information:
Name: SAFEWAY, INC
Address:
PO BOX 85001 98015 -8501
BELLEVUE WA 98005
Contractor License No.:
Permit No.: 20170105
Issue Date: 1/18/2017
(Work must be completed within 180 days)
Phone: 206 - 455 -6530
Owner: SAFEWAY INC.
N/A
Phone:
Expires:
Project Information:
Project: COMMERCIAL REMODEL
Description of Work: REMODEL STARBUCKS KIOSK
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Lot: N/A
Item Contractor Fees
BUILDING SAFEWAY, INC $ 1,470.93
PLUMBING SAFEWAY, INC $ 27.00
FIRE SPRINK 1/31 / 201 7 SAFEWAY, INC $ 134.26
TOTAL FEES: $ 1,632.19
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 Washington.
Signature Date
Firm I A 1 ii C -1-r ir ^J e" C
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of Mi
(36 �) 458 -3244
REC #: 00257692 1/31/2017 11:32 AM
OPER: CO TERM: 001
REFS`:
PAID BY:
ACCT #: XXXXXXXXXXXXXXXXXXX
AUTH #: 66985D
TRAN #: 000000004067
TYPE:: PURCHASE
TRAM: 33.0000 BUILDING PERMII3
20170105 134.2(CR
SAFEWAY, INC
1109 YELM AVE E
FIRE SPRNK 134.2(CR
TENDERED: 134.26 CREDIT CARD
APPLIED: 134.26 -
CHANGE: 0.00
2ot7o p6_
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: Oct S,yAm hVP_ Parcel # :9 I06X3gg03
Zoning;
Current Use: P.ila� 1—r-004 Proposed Use:
C New Construction C Re -Model I Re -Roof / Tenant Improvement
❑ Plumbing C Mechanical *Fire Prevent/Suppress/Alarm ❑ Other
Project i - . • T. • e - • • � l r .i t t'. • is i I�I� M
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? t-40 If yes, a
completed environmental checklist must accompany permit application.
BUILDING OWNERITENANT NAME:
ADDRESS a i EMAIL
CITY i[ lit i_r3 }- treol@TATE_fA_ZIP OL15°t TELEPHONE
ARCHITECT /ENGINF -ER LICENSE #
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERAL CONTRACTOR flamm a M10 61 1 EPHONE
ADDRESS 01.6 r EMAIL io;t)r 0- kc - rc„nc�V-.,rc5m
CITY Hum l +na STATE I 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 #
ADDRES �'� _ � KT EMAILp�j�l . S.QCti/ot`t � � .us
CITY V- PiAnaon STATE W _ZIP ft!54 5?_ FAX LA-iS - %19 1- 3c� 3 6
CONTRACTOR'S LICENSE # .s'r` Qlvlkr,E P DATE CITY 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 Yalm.
AppIicaqVXSMgpAXqe Date
Owns Contract Owner's Agent/ Contractor's Agent f 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
(360) 458 98aB
105 Yelrn Ave W (NO) 458 -3144 FAX
Yelm, WA 98597 www.ciyelm.ma.uj
vut.w
U•
SCOPE OF WORK
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — l
I I
1
I i
I 1
R 1 R II Oa
I I
I I
--------------------------------
SCOPE Of WORM
1. REMOVE 2 SPRINKLERS FROM EXISTING KIOSK CANOPY, 2, INSTALL 2 SPRINKLERS
INTO NEW KIOSK CANOPY.
DESIGN CRITERIA
OT. 13 (2615 EDITION)
HAZARD: ORDINARY
MATERIAL NOTES
1. ALL NEW PIPE TO BE BLACK OYNA- THREAD PIPE.
2. ALL NEW FITTINGS TO BE BLACK. IMPORT CLA88 175 DUCTILE IRON,
3. ALL NEW NMGER6 TO BE SAMMY SCREWS UNLESS NOTED OTHERWISE.
GENERAL NOTES
1. ALL MATERIAL AND EQUIPMENT TO BE IAJFM APPROVED.
2. PIPING DIMENSIONS ME CENTER TO CENTER EXCEPT RISER, DIMENSIONS
AND MANS SHOWN THUSLY (1.6) WHICH ME END TO EO.
3. EARTHQUAKE BRACING SHALL BE PROVIDED IN ACCORDANCE WITH NFPA
PAMPHLET NO, 13.
4. PIPE HANGER ANO METHOD OF HANGING TO S E N ACCORDANCE WITH WPA
PAMPHLET NO. 13.
5. PIPING SHALL BE IN ACCORDANCE WITH NFPA PAMPHLET NO. 13.
6. JOINING OF PIPE AND FITTINGS. THREADED AND WELDED. SIUILL BE IN
ACCORDANCE PATH NFPA PAMPHLET N0. 13.
7. OWNER TO PROVIDE ADEQUATE HEAT TO PREVENT WATER IN PIPES FROM
FREEDNG IN AREAS PROTECTED BY A WET PIPE SPRINKLER BY STEM.
8. STRUCTURAL ADEQUACY OF THE BUILDING TO SUPPORT THE SPRINKLER
PIPING IS THE RESPONSIBILITY OF THE OWNER ANDIOR HIS STRUCTURAL
9. OWNER 15 RESPONSIBLE FOR ALL APPROPRUITE MAINTENANCE AND
PROTECTION OF THE FIRE SPRINKLER SYSTEM.
IV ALL W WING OF ELECTRICAL COMPONENTS TO BE DONE BY OTHERS.
11 A •INTG OF PIPE, PREPARATION OR PROTECTION OF PIPE FOR
PANTING SHALL BE PROVIDED BY OTHERS AND IS NOTPART OF THIS
CONTRACT.
12. THE FIRE SPRINKLER SYSTEMS SMALL BE MONITORED 24 MOORS A DAY BY A
CENTRAL STATION AND 16 NOT PART OF THIS CONTRACT.
13. EXISTING PIPE IS SHOWN AS DASHED,
R WASHINGTON STATE �
j CERTIFICATE OF COMPETENCY
PIKE PROTECTION SPRINKLE-ST l MS
Richard J. Stewart
• 3636. 1100 -C Level
Western States Fire Protection Company
WESTESF136QF
FIRE SPRINKLER PLAN LEVEL 1
SCALE: 1/4" – V -0 ". -.
NO2M
i ,. `� 01/1112017 Expl r.A i
Sig. 4 . Data
• - -�
SYMBOL LEGEND
REVISIONS
SPRINKLER LEGEND
APPROVAL'
Western States Fire
SAFEWAY 1619 SBUX
SHEET
CITYOFYELM
-.-. •�u
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1109 YELM AVENUE
—
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DRAWN By EMILYSERVAS
SPRK. ON SHEET '2
Protection Company
146901A 55 AE. IN:— 101 � REDMOND. WA -98052
YE LM, WA 98597
of
•
' - PRA
SPRK.ON )OS 2
P« 58810/ F. 426$81W3C
FIRE SPRINKLER PLAN
1
DATE.OVI2047
% WES-ESF136OF
Karen Bennett
From: Emily Servais [Emily.Servais @wsfp.us]
Sent: Thursday, January 19, 2017 10:51 AM
To: Karen Bennett
Subject: Fire Sprinkler Permit Application
Attachments: KS3157_Revision00_(SBUX_Canopy) 11x17x.pdf, SKM_C36817011910540.pdf
Hi Karen,
Please confirm receipt of this application and plan.
Thank you for your help!
% Western States
Fire Protection Co.
Emily Servais I Designer/ Project Manager
Western States Fire Protection Co. WSFP.COM
14690 NE 95`h St Unit 101, Redmond, WA 98052
M: 206.771.429310: 425.881.01001 F: 425.881.3030