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BLD-05-0202City of Yelm Community Development Department Building Division Phone: (360) 458.8407 Fax: (360) 458.3744 Applicant: Name: Yelm Senior Center Address: P.O. Box 474 Ciry: Yelm Property Information: Site Address: 76530 103rd Ave. SE Assessor Parcel No. 64303600302 Subdivision: NIA Contractor Information: Name: Williams Scotsman Contact: Address: 14219 Smokey Point Blvd. City: Marysville Contractor License No: Expires: 12119/06353 Project Information: Project: New Senior Center Description of Work: Modular Building Permit Phone: 458.7733 State: WA Zip 96597 Lot: N/A Phone: 360653-5790 State: WA Zip: 98271 Business License: Sq. Ft. perfloor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0 Heat Type (Electric, Gas, Other): OTHER Fees: Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc Building Permit-Other 1,050.00 0.00 0.00 0.0000 0.0000 $1,000 Building Plan Review 682.50 0.00 0.00 0.0000 0.0000 State Building Fee 4.50 4.50 0.00 0.0000 0.0000 Water Meter (Commercial) 650.00 300.00 0.00 0.0000 0.0000 Sewer ERU (LID) 8,307.00 0.00 8,307.00 2,769.0000 3.0000 ERU Sewer Inspection 435.00 0.00 435.00 145.0000 3.0000 ERU Water ERU 4,500.00 0.00 4,500.00 1,500.0000 3.0000 ERU Traffic Facilities Charge 7,447.50 0.00 7,447.50 750.0000 9.9300 Peak PM Trip TOTAL FEES: $23,076.50 Applicants Affadavit: I certi ~have'read aJ to b rue correct Finn information contained within the application and know the same proposed structure is in conformity with all applicable City of i zoning and land subdivision, and in addition, all covenants, plying as a contractor, I futher certify that I am currently Date Permit No: BLD-05-0202-YL Issue Date: 08/15/2005 (Work must be started within 180 days) Receipt No: 319830 # Sets of Pdnts: Flnal lnspectlofn'~-~~~~'~~~i~~!;T,~ Daq\z~~yz `` / By: ~EC~iv~o AUG 1 2 2005 pgP.~,........~ 000-0 :[^~*~*xx**:[*^xx~ S T A T E O F W ASH I N G T O N x**~**** PAGE S: 1 RPT DWP827SW D I R E C T D EPOS I T N O T I F I C A T I O N (360) 664-7779 YELM CITY OF DEPOSIT DATE: 08/15/05 ATTN: AGNES BENNICK PO BOX 479 VENDOR NUMBER: SWV0007884-00 YELM, WA 98597-0479 FROM: COMMUNITY, TRADE & ECONOMIC DE 1030 PAYMENT S• 319830 BATCH• EW-105 PHONE B: (360) 725-2739 PYMT TOTAL: 23.078.50 INV DATE INVOICE NUMBER / MESSAGE ACCOUNT NUMBER DOCUMENT 0 AMOUNT 0264002051 00532 23,078.50 CDBG INVOICE S3 TOTAL FROM COMMUNITY, TRADE 8 ECONOMIC DEVELOP 23,078.50 TOTAL DIRECT DEPOSITS FROM STATE OF WASHINGTON 23,078.50 City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360)458-3144 Applicant: Name: Yelm Senior Center Address: P.O. Box 474 Project Information: Project: New Senior Center Description of Work: Modular Building Permit Site Address: 16530 103rd Ave. SE fees: Item Building Permit -Other Building Plan Review State Building Fee Water Meter (Commercial) Sewer ERU (LID) Sewer Inspection Water ERU Trafhc Facilities Charge Acct Code 032 001-322-10-00 100 001-345-83-00 160 001-386-00-00 712 401-843-80-01 802 412-343-50-01 805 412-343-80-00 712 401-343-80-01 420 120-345-85-00 TOTAL FEES: City' Yelm Item Fee 1,050 00 682.50 4.50 650.00 8,307.00 435.00 4,500.00 7,447.50 $23,076.50 Permit Fees Schedule Permit No: BLD-05-0202-YL Phone: 458-7733 State: WA Zip 98597 Assessor Parcel NO. 64303600302 Base Amt Unit Fee Unit Rate No. Units Unil Desc 0.00 0.00 0.0000 0.0000 $1,000 0.00 0.00 0.0000 0.0000 4.50 0.00 0.0000 0.0000 300.00 0.00 0.0000 0.0000 0.00 8,307.00 2,769.0000 3.0000 ERU 0.00 435.00 145.0000 3.0000 ERU 0.00 4,500.00 1,500.0000 3.0000 ERU 0.00 7,447.50 750.0000 9.9300 Peak PM Trip CITY + *- COMMERCIAL BUILDING wtrrMl7 ~aPPLICATION FORM Project Address: ~3. f~3L' ~~' ~ ,~, ~i ~~ <' Parcel #: ~ y ~ O ~~ /^ C~ -~L 7 Zoning; Current Use: n Proposed Use: S"~~ lh 1~ ( ~ ~~ ~'"d' New Construction U Re-Model / Re-Roof /Tenant Improvement u Plumbing u Mechanical U Fire PrevenUSuppress/Alarm U Other Project Description/Scope Project qA,f, I R ~~~5 Building Area sq. ft) Parking Garaged" Floor~ub-~-~2ntl Floor 3"' Floor_ Building Height ,+[lc ~ Y,~~ Are there any environmentally sensitive areas located on the parcel? ~ If yes, a completed environmental checklist'must accompany permit application. s.~ ~;~v~ v~5 /a, sT BUILDING OWNERITENANT NEE: ~ c c-c- - -rc 'L. ~ t. ~C_. ~ ~7 ADDRESS~?o / r~ /m fit' -r' ~ !w N7 ~ EM ~/ ' ~~ u~ 'e+~17 CITY STATE u'.~ ZIP ~~ TELEPHONE s~ " _ i ARCHITECT/ENGINEER ~+' '~ ~"Y i rv ~ LICENSE # v!- .l'xn ~ 77 ADDRESS ~'S rS { n of a - EMAIL CITY/;-/,~"t'e:, STA /~'A ZIP 9b~3~ TELEPHONE 3tili 'I~fG+t~Y! ~ GENERAL CONTRACTORG %, //r9 k ~ S ~~ o f s 419rt . ~,"TELEPHONE ~.f 3- ~y ~ - ~ 3 3 `~, CITY /'Ae ; `F'- ~ STAJ~ 'ZIP 9xo f ~ FAX 4-;-3 - is 9/ PLUMBING CONTRACTOR ADDRESS CITY STA CONTRACTO 'S LICENSE EXP MECHANICAL CONTRACTOR TELEPHONE ADDRESS EMAIL CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # Copy oT Cky Mkigation documemadon (TFC). 1 hereby certify that the above {rdormallon Is correct and that the eonstruetbn on, and tM occupancy and the use of the above described property will be In accordance with iM Iswa, rules and regulations of the State of Washington and the Chy of Yelm. ~.~//LrL~L -.~J/fi~/i/Lf-~/1 ~ll!CELTLC'9~ ~ / t' ~J~~ Applicant's Signature ~- Date Owner /Contractor! Owner's Agent /Contractor's Agent /Tenant (Plea a 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 Avenue Weat (360) 458-3835 I'O Bos 479 (360) 458-3144 FAX Yelm, WA 98597 mmru.ci.yelm.wa.ua L~ "° ~~ ~pF iMfp~ e R,e_~ce~iv'ed of~I 1 l,r 1 DNt A.. ion (.4'191 / ~;/l,~,t .Y ~L Ai~~,c~n/ ,Q.C~~ `~~ --Dollars - -r, - D b o ~' ~ C3 3 s o o P2- 50 8 ~ al TOTAL ~ By i S nior Ac unting Clerk ORIGINAL -WHITE DUPLICATE -CANARY Yelm Clerk -Treasurer TRIPLICATE -PINK CITY OF YELM TREASURER'S RECEIPT 119 ® Yelm, Washington ~ - / J 20,E Received of C!.f~,~~ ,~.e.a-r~-~ 1196`7 l ~l_~-l~ 7~a~ ~fCo,-,1..~ e-~ --t'a~ II~n~/ rlnllnrs ~ ~ O 3 0 3 80 0 3 ~ ~ TOTAL a3 p7 5Z; BY ~,~y~-cry Senior ounting Clerk Yelm Clerk -Treasurer ORIGINAL -WHITE DUPLICATE -CANARY TRIPLICATE -PINK i CITY OF YELM TREASURER'S RECEIPT 119 0 5 ,.. 1 ~' "~ ro ~ G w w m ~, '$' 7 Sp SO~m Y L8 ~ Jn Dd ~ < x t y ~~ ,ppo ,~ .~ ~ ~ ~ O x 1 ' d ~ V{~ ~~ ~.' ~~~ I ~ ~ J ~ ~ v, `a y ~ 7° x 1 ~ o ~ a ~ ~ d 1 ~ ~, a d ~ a r 1 ~ 1 a+ ~ ` ~ m m °~ ° x ~ ~ °' m m i` ~ ~ ~ ~ a ~~ m 1 1 ~ m z { ~ c~ O r~ ~ o ~ µ x v z w o ~, ~ ~ ~; m ~ ~ n ~. x ei x ~'~ ~, i '~ n m Z 0 CJ"J c_5 N ` m N t ~; m o I ' PRibf~ O* A 1 :r m {1 ats"f ~ 4 n~ wmv-1.,~~ X3'0 ~+'~ D ~ J ~-~ r f0 A wl' -=:~`I : YF I.1 St LIFP DEPT. FRX Nfl. :36R-458-E1166 Nov. 01 ?GJ05 (~4: 1C~PM P1 1f p~ THE rpe 4 ®~_ y M FAX TRANSMISSION ~ CITY OF YELM "'"°"'"°'° 1' O BOX 479 - 931 NP ROAD NE n ~ YELM, WA 98597 ,t 1~k\ 360-458-8411 ~ ~ FAX'360-458-8166 TO: ~ ~ H r; .,~ FAX#: From: ~ZAND`l' llATE: ~ 1 _ J ~ o ~~ PAGES: 1 ,including this Cover sheet Subject: ~E~.m S~,u,~2 C.C~TC~ F1~~~-- COMMENTS: ! ~, S3 Q ~~_L,~I 103'=~ A~~~ S,C L'L ~ "`* ff you do nol receive all copies or any copy is not legible, please call (3G0) 458-8411 as soon as possible. 1 FIIO ~~~~o) -. _.~ Q= ~Iq •~ 4eparutlent of Labor and industries Baia e..s column ('h!rk Pa Factory Assembled Structures Q~~ i) r• ];ii . f 30.90 Pd Box 44430 Olympia WA 98504-0430 NOTIFICATION TO LOCAL ENFORCEMENT AGENCY www.wa.gov/IRYFAS! D~ 397 (ease sensitive) 6/30/05 M The Fattory-Built utrlt identlfled below requires completion work at the MPB site as snecifled. WHITLEY EVERGREEN ~9°0°~n WILLIAMS SCOTSMAN mtgr"~~ 1204-102-A/G Ueptsri 1`p Installation sddreu Type of conuuction l7eeuoenov hTA al site 201 YELM AVENUE VB A-2 AUG 30 City Siate Z[PH County Phone number YELM WA THURSTON Imtatlatioo dte is In: ~ Ciy ^ Ctwny DESCRIIiE TTEMS REQUIRING COMPLETION WORK AT THE SITE BUILDING DEPARTMENT www.wabo.org/ INSERT NAME AND ADDRESS IN SHADED AREA FLECTRi_CAL DEP.~RTM_F,NT www.wa.govlln!/elcetrkaU INSERT NAME AND ADDRESS IN SHADED AREA °t BUILDING OFFICIAL TO` LABOR & INDUSTRIES -E~CC~-t cp~L P.O. BOX 479 7273 Linderson Way SW YELM, WA 98597 Tumwater, WA 98501-5414 44810 SEE ATTACHED SHEET FOR ITEMS TO BE SITE INSPECTED 1. ELECTRICAL SITE CONNECTIONS TO UTILITY 2. PAD MOUNTED HVAC UNITS 3. ROOF TOP MAKE UP AIR UNIT 4. MATELINE CROSSOVERS 5. LIGHTING: TESTING 6. LIGHTING COMMISIONING REPORTS 7. ELECTRICAL CUTOFF AT FIRE SUPPRESSION SYSTEM IN GREASE HOOD S. SPRINKLER FLOW SWITCH AND ALARM ~To2, 1,f2-t.-~ k~L~) 1.J .' 1 ~(.~,~., y~~t/<(~.3©S5 I IMam~taenaers mme t~DAVE BAL4 ~1 1 F623-013-000 (PDF) ootlfication to Wcel enfoteemenl agemy f 1-00 crap - ElaMrical section Calory - Impawr Pink - Buiiditta dputmettl r...U.....,,t r.......... Whitley-Evergreen, Inc. 14219 Smokey Point Blvd., #10, Marysville, WA 98271, Phone (360) 653-5790, Fax (360) 659-7735 whitlevna,whi tl evman.com Dave Ballard - dballardQwhitleyman.com NLEA ITEMS FOR YELM SENIOR CENTER S'fJ- l2~"-I~z 1. FOUNDATION SYSTEM & TIE DOWNS 2. MISC • BELLY BAND, DECK AND RAMPS • INTERIOR /EXTERIOR MATELINE TRIM • SITE INSTALLED FLOOR FINSH • MEMBRANE ROOFING AT MATELINE 3. STRUCTURAL: • MATELINE BOLTING (ROOF/FLOOR) • STEEL MATELINE HEADER @ KITCHEN • WATER HEATER SEISMIC ANCHOR (80 GAL) • DRAG STRUT W/ HD ANCHORS AT CENTER MOD 4. PLUMBING: • MATELINE CROSSOVER TT&P VALVE PIPING TO APPRVD DRAIN • HVAC UNIT CONDESATE DRAINS • SUPPLY/DRAIN SITE CONECTION • GREASE TRAP SYSTEM • 80 GAL HWT • TRAP PRIMERS AT FLOOR DRAINS 5. MECHANICAL: • MATELINE CROSSOVER • PAD MOUNTED HVAC UNITS • REFRIGERANT LINES • ROOF TOP MAKE UP AIR UNIT • SITE INSTALLED MAKE UP AIR SYSTEM HVAC START-UP & BALANCING • COMMISIONING REPORTS (PRE & FINAL) • ROOF TOP FRESH AIR INTAKES • ROOF TOP EXHAUST FAN HOODS • GREASE AND STEAM HCCG EXHAUST FANS 6. FIRE: • SPRINKLER MATELINE CROSSOVERS • SYSTEM TIE IN TO UTILITY • TESTING • FLOW SWITCH AND ALARM • GREASE HOOD SUPRESSION SYSTEM 7. GAS: • GAS PIPING AND CONNECTIONS • AUTO GAS SHUTOFF AT FIRE SUPPRESSION SYSTEM IN GREASE HOOD 8 SITE INSTALLED EQUIP: • WATER HEATER (80 GAL) • COMMERCIAL KITCHEN EQUIPMENT (CONNECTIONS, ANCHORING PER MFR SPECS) • ROOF ACESS LADDER & WALK OFF PADS TO MAKE UP AIR RTU • SERVING WIDOW AND COUNTER • GREASE AND STEAM HOODS S. Whitley, IN -Dallastown, PA - Rochr.~sier, IN - tt-1arysville, WA 3766NLEA.doc - I -