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BLD-05-0108City of Yelm Community Development Department Building Division Phone: (360)458-8407 Fax: (360)458-3144 Applicant: Name: Roush Environmental LLC Address: 11409 66th Ave. E City Puyallup Property Information: Site Address: 509-B Yelm Avenue East Assessor Parcel No. 22719342901 Subdivision: NIA Contractor Information: Name: Osburn Steel Buildings Contact: Atldress: 216 Puyallup Ave. #149 City: Taeoma Contractor license No: OSBURNS8054LN Expires: 11175/06319 Project Information: Project: Walt's Muffler Description of Work: 3240 sf Automotive Ropair Sq. Ft. per floor: (15C) 3240 (2nd) 0 (3rd) 0 Heat Type (Electric, Gas, Other): GAS Fees: Item Item Fee Base Amt Unit Fee Building Permit 100-500k 1,027.35 993.75 33.60 Building Plan Review 667.77 0.00 0.00 Mechanical Permit 72.75 0.00 0.00 Plumbing Permit 48.00 20.00 28.00 Sewer ERU 5,417.00 0.00 5,417.00 Sewer Inspection 145.00 0.00 145.00 Traffic Facilities Charge 6,967.50 0.00 6,967.50 Sewer Deposit 50.00 50.00 0.00 Water Deposit 40.00 40.00 0.00 State Building Fee 4.50 4.50 D.00 TOTAL FEES: E14,439.87 Permit No: BLD-05-0108-YL Issue Date: 04/11(2005 (Work must be started within 180 days) Receipt No: 36121 Phone: 263.606.7572 State: WA Zip 98373 Lot: NIA Phone: 253.847-9830 State: WA Zip: 98421 Business License: Garage 0 Basement 0 Unit Rate No. Units Unit Desc 5.6000 '6.0000 $1,000 0.0000 0.0000 0.0000 0.0000 7.0000 4.0000 Fixture 5,417.0000 1,0000 ERU 145.0000 1.0000 ERU 750.0000 9.2900 Peak PM Trip 0.0000 0.0000 0.0000 0.0000 O.D000 0.0000 Applicant's Affadavit: certify that I have read and examined the information contained within the application and know the same ~ be true and correct. I also certify that the proposed structure is in conformity with all applicable City of elm regulations including those governing zoning and land subdivision, and in addition, all covenants, rsements and restrictions of record. If applying as a contractor, I futher certify that 1 am currently 3istered in the State of a~s~hin~gfton. nature ~ ~ ~ _ Date y~ ~/~ I # Sets of Prints: Final h Date: By: _ r] ~ ~ L7 7 M N ~ ~. m ,.] "' O ~ N m _' y 1 ~ t » ~ " cn b r ~ * i ~ '~ ' 1 t~ -,'~ a rC. t+ C , STS" AT }- ~y N ~ ~ - ~- -r _ i"i Ch ---i _ s ~. C7 ~S - _. w, nom', o- 5 M "' r bz c, x ~~ ~f+ ~ © ~ c~ ~ -.S O `t ..] M' ~ ~, .F+ ~ ~ y a ~~ ca y ,~ z .,. ~~a 7 w ~ cw ~ r ~ C n a +, . b r ~ H ~ N CTS ~ h M xr r z ~ C U7 Q ,p C~ x c~ n M H To a s s n x C A r c~ H Z L7 r u~ r~ N B 0 c v. r 0 .n 0 c z G 2 d Cy H .4 z ~ H ~,, - z r `~ N ~ O r ~ r r 'qp N ~ 'P x > = ~ ~' a ~ n ~, r z Cl y x N CTS C: x r _, m - W - ~9 _ ~ 9 -_~ ~ T ((('''T^~~~ ~I } ~ ~~'~ i~ f'1 y ~~ror~ G r ~ .~~ +_ ' r ~~ n ( ~ i ~ a7 7 ' ~..~ . f' ~ ~ ' z M ~ ~ ~ _ ~ . ~ ~, CTS B G 6' CTS w v.+~ ~~ iPi O z ~ ~ ro es - . _ °, ~yw. .tq G~ ~ ~ R° ~ ~~ W ~ ~ ~ -_ ,. __ 5 [ ~~ ti t..~ .~'Ln ~C7 q w a~ {~ 9 r z v u r:z ehw r " .3 ~ r1 ~ [ w t~ n ~ G _ y r+ ~ C ,- ~ ~ z a ~' 7 / iJ CTS a ~D D --w. R, N -, ~ M ~ N ~ ~~a an F -' ~. o ~ 5 ~ ~ ~ ~ ~ tea` y + -_ r '^ = n ,.3 ~ b c ~ N ~ ~ ~ r~ _ L G B r. ~- ~ CT7 W L~ ~ n ~ 1 H r x N b ch y `3 'J' m -^ ~ a ~ ~ y i ~ ~ m ~~ 7 ~ m , ~ ~ ~ v. ~ Y ~ ~ ~ ~ :~ 'a Y ' ' c~ ',a ~ ~ C'1 x ~ ~ ~ ~ t =. ~ ~z H ~"} M S~.-' ~~ ~ = O ~ ~ w _ ~ i° ~, ~ 6+• .. ------~- CITY OF YELM INSPECTION LOG PROJECT PERI`91T NU1~IBER U5- O t a ~ ,4DDRESS SQ9 - ~ y~•~ ~rL ~ SET BACKS Date: Front Rear Side Flanl:ine Side FOOTI:~C REBAR Date r FOOTING \\'ALL ^ 12" ^ 6" ^ 16" ^ g„ ^ other ^ other ^ required gents \\'ALL REBAR Date: CO~1B11ED FRA?~SEI E\TERIOR SHEAR \~'ALL IISPECTIO\' Holddo~~ns ~ Shear ;wiling C Frame ^ Gas Propane ^ Plumbing ^ Alechanical ^ 11St'LATlO:~ Comments ^ Gas ^ Electric ^ Other ^ Foam and Seal '^ Vapor barrier ^ P\'A SHEET ROCKJSHEAR \1'ALL \AlL Comments OTHER Comments FINAL ^ Se~~er Final ^ Electrical ^ Cis it Final ^ Landscape Final ^ C of 0 ^ Address ^ Insulation ^ Site Drainage '~ Side~ralk CITY OF YELM COMMERCIAL BUILDING PERMR APPLICATION FORM Project Address: ~ /~'' ~ \~~ ! .- i~ ~,'~ Parcel m: '~ -? ' ' ~' =L- ~ '`~ '~ Zoning; Current U'se; Proposed Use: New Construction ^ Re-Model / Re-Roof /Tenant Improvement ^ Plumhing ^ Mechartica! C Fire PrevenUSuppress/Alarm ^ Other q / ~~ __ Project Descriptic+~iG~nne ei Work l ~;i -ll~ h%~L / ~~'y~~. ~I-/`l-G~ ` ~~~ f Building Area (sq. ft) PCarking Garage 1~` F1oo!~(~,:~2n° Floor 3f° Floor Building Heigh, / Are there any environmentally sensitive areas located on the parcel? ~ a' if yes, a completed environmental checklist must accompany permit application. BUILDINGQ4yNER/:TENA~IT NAME: !G ' i_~ ~~'~ 5 ~-~ I ADDR~S ~ 1~ ~ ~ ~ %~ ^~ ~ T L ~- ~ CITY L ~I ~+ sLY STATE i r.'d ZIP'~~%<7 TELEPHONE'?-4l ~c/<i -2c • /'-~ AFiGHI')riCT~ENGINEEI~ --r.+ ~ `~~~ -:~~ LICENSES /{7'i= ADDRESS CITY STATE ZIP TELEPHONE 2i.n)~ '=f-1'--.=- MECliANICA~ ~Qt~kTFiRCFOR TELEPHONE ADDRESS CITY STATE ZIP FAX CONTRACTOR'S LICENSE # EXP DATE_CITY LICENSE ;# Copy of C1ty Mlttgatlon documemation (TFC). I hereby certify that the above intormatian is correct and that tfie construcdon on, and the occupancy and the use of the above described property will he in accordance with the laws, rules and regulations of the State of Washington and the City of Yew ~ ~' i ~J . , .;a' e ate Y Owner's Agent /Contractor's Agent /Tenant (Please circle one.) ~II permits are non-transferable and wiii 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 C?,Cammuniry Development\Forms & Procedures\Building Permits\CommBldgPermirAppdoc Page 3 of 4 Look Up a Contractor, Electrician ~- Plumber License Detail ~ r~-a~ Topic Index ~ Contact Info ~~„ ~ Search ~^~ _~~ ~ ,~:•..s~'."d":"'"`I ~~~.'', Hame Safety ~ Claims fi Insurance ~ Workplace Rights Find a Law or Rule Get a Form or Publication Look Up a Contractor, Electrician or Plumber Page i of 3 ~ v Trades fr Ucensing General/Specialty Contractor A business registered as a construction contractor with L&I to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. License Information License OSBURS6054LN Licensee Name OSBURN STEEL BUILDINGS INC Licensee Type CONSTRUCTION CONTRACTOR UBI 601624608 Verify Workers Comp Premium Status Ind. Ins. Account Id Business Type CORPORATION Address 1 216 PUYALLUP AVE 149 Address 2 City TACOMA County PIERCE State WA Zip 98421 Phone 3604000450 Status ACTIVE Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 6/15/1995 Expiration Date 11/15/2006 Suspend Date Separation Date Parent Company Previous License OSBURD'101MJ Next License Associated License Business Owner Information ' ~---~~~°~-~-~~~ __~~ ~~~/ln;/bbin/Detail.aspx?License=OSBURSB054LN 4/5/2005 Look Up a Contractor, Electrician ~~ Plumber License Detail Name Role ~ Effective Date ~ Expiration Date OSBURN, JAMES B 01 /01 /1980 O5BURN,FRANCE K 01/01/1980 Bond Information Page 2 of 3 Bond Bond Company Account Effective Expiration Cancel Impaired Bond Received Bond Name Number Date Date Date Date Amount Date DEVELOPERS SURETY $ Until #3 INDEM CO 8590480 11/12/2002 Cancelled $12,000.00 11/15/2002 AMERICAN STATES INS Until #2 CO EX922034 04/25/1998 Cancelled 07/21/2001 $6,000.00 AMERICAN STATES INS #1 CO EX922034 04/25/1995 04/25/1998 $6,000.00 Information No Matching Information Insurance Information Company Policy Effective Expiration Cancel Impaired Received Insurance Name Number Date Date Date Date Amount Date SCOTTSDALE #7 INS CO CL50962089 11/12/2004 11/12/2005 $1,000,000.00 10/28/2004 SCOTTSDALE #6 INS CO CL460100124 11/12/2003 11/12/2004 $1,000,000.00 11/14/2003 EVANSTON #5 INS CO GL1124532 11/12/2002 11/12/2003 $1,000,000.00 11/15/2002 SAFECO INS CO OF #4 AMERICA O1CE771057 04/25/2000 04/25/2001 11/22/2000 AMERICAN STATES INS #3 CO 01CE55982510 04/25/1999 04/25/2000 SAFECOINS #2 CO TBD 04/25/1998 04/25/1999 MARYLAND ~ #1 CASUALTY EPA22349808 04/25/1995 04/25/1998 Summons / Comolaints Information Tax Summons / Cause Warrant Dismissal Complaint Complaint Judgement Judgeme Complaint Number Id Plaintiff County Date Date Amount Date Amount DEPT OF #3 002315791 REVENUE KING 12/18/2000 $6,000.00 $0.00 BHP STEEL BLDG PRODUCTS ~~~----~~~ ~..~ ..~~~/tn;/hhin/Detail.aspx?License=OSBURSB054LN 4/5/2005 Look Up a Contractor, Electrician ^~ Plumber License Detail . - ti Page 3 of 3 tt2 992264002 USA KING 01/11/2000 $15,162.90 $0.00 SCB ENTERPRISES N1 982005460 INC CLALLAM 07/08/1998 $18,368.17 $0.00 Start a_New Search Printer Friendly Version .,~ *.- - s ASout L&I I F,nd a~eb a L'±i ~ Infcrmaao ~ er, espano~ I Site Feedback ~ t~.q. ~' ~ 1 800.547 8357 "'_ r. _..,,~ .~ ., _, .t..., ..t . ..~,,.°:r, ~4`......AY8S11fR910R .~~~ y .. ..~ ~ ..._ ~ ~:. ~ i ~.j s~~~rd .~~ i __' u~ n -. i•al i ,~ ~... Vhif dry ~ ji t" .~nl'~ li~. is 4/5/2005 ...__.,,r.......a~~ ,,,a awllni/bbin/Detail.aspx?License=OSBURSB054LN ~~ Inforn~ation ~~ToBuild On tr.~rr».+ro - ca....rw,.D • ~r.ero SEATTLE OMSION 24113 56TH AVE W. MOUNTLAKE TERRACE, WA 98043 (425)246-2400' FAX (425) 246-2401 TACOMA ONISION 10025 SO TACOMA WAV, SUITE H7 TACOMA, WA 96999 (253) 589-0804' FAX (253) 569 2136 FR ~ PORTLAND DMSION 6032 NO. CUTTER CIR. SUITE 460 PORTLAND, OR 9]21] (503) 269-1776' FAX (503) 269-1918 CIENT~ ~~ ~ DDRE5$ PROJECT~NO:~~ pERMfT N0. DATE W.O. _ _ _ MUNICIPALITY: .. ENGINEER ATTENTION - - -- ARCHITECT p:0. Nv; _ COhftiRAGtOR PROJECT PROJECTADDRESS FIELD REPORT EQUIPMENT IDENTIFICATION AND S/N#: COPIES TO: INSPECTOR: DATE: -------------- ITEMSINSPECTED TO -PPROVEO.PLANS.AREi. CLIENT CONTRACTOR ®ENGINEER ®BUILDING DEPT. ARCHITECT SUPPLIER - CONFORMING 0 NONCONFORMING 'Tn.e nqn is Povi4e6 rer me iaemnoon a un aiem enh m. npoanon of m.e nqn, q em m.lnoe, ene id v.nemn.l w e dim qM. M em nems, erupt in bll, wmoul me Nll grmeeion 4lPMenioml Servia liMUSlnee. Inc is goddn4.' 'leis uNRUtion eeeed t4 be eaurery of Me nauM o6dlne6 hom lee Bawl Oat g6omg4 endor o6serve4ena rtub wMln lee bfne4 euq of tlro w4A. GNfiutiq eeell not b gneWe4 b npeesnt en insgLGq, epp4vel ar eaepMrce of oMer •>eouele4 xo4i or. wmnh pl4etipn or xaMedlih a Me epetlegGOn requinmenta.' Certified Report by Professional Service Industries: NAME ON OFF ST OT MILES OTAL HOURS Date TS - 98-1