20070186 SE Permit Pkg~-~... ~~+,~r-..~.~..~~.._.,_ ' . . . . _ _ . ..'. -- -_ -. _r:~ MIAI~IIN~~IMII~PId - . _ "_ ." . . . . . . . . . . . .. . . . .. .. . -
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City of Yelm
Community Development Department
Building Division
Phone:(360)458-8407
Fax:(360)458-3144
Applicant:
Name: Cascade Deli-Mart
Address: 1506 Yelm Ave. West City: Yelm
Property Information:
Site Address: 1506 Yelm Ave. West
Assessor Parcel No. Subdivision:
Contractor Information:
Name: Contact:
Address: City:
Contractor License No: Expires:
Permit No: SE-07-0186-YL
Issue Date: ~NvtT~sued `~~/~~~'~
(Work must be started within 180 days)
Receipt No:
Phone: 400-0333
State: WA Zip 98597
Lot:
Phone:
State: Zip:
Business License:
Project Information:
Project: Cascade Deli-Mart
Description of Work: Grand Re-Opening of Deli-Mart
Sq. Ft. perfloor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0
Heat Type (Electric, Gas, Other):
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
TOTAL FEES: $0.00
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Applicant's Affadavit:
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 futher certify that I am currently
registered in the State of Washington.
Signature
Firm
Date
City of Yelm
(see REVERSE for regulations)
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NAME OF PROJECT `h ~ (~.~, ~~ ' ~ C ~ ~°~~ I ~
APPLICANT/BUSINESS NAME ~ ~~ " ~/` /`~ /~'
Mailing Address ~ .~ ~ ~ ~
City, State and Zip Y.ur '/, ~
Telephone ~- ~ ~~~ ~~=' ~' EMAIL
City of Yelm Business License Number
SITE OWNER - c /~ ~'" - t= t
Mailing Address ~~ ~~-~
City, State and Zip
Telephone EMAIL
SITE ADDRESS/LOCATION ~J ~Y-l -
SITE PARCEL NUMBER
SUMMARY OF R. QUEST ~" ~fi ~ ~r ~ ~ ~ .w ~
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START DATE (iC o END DATE ~~+ ` O
I affirm that all answers, statements and information above and submitted with this application are complete and
accurate to the best of my knowledge. I also affirm that I am the owner of the subject site or am duly authorized by
the owner to act with respect to this application. Further, I grant permission from the owner to any and all
employees and representatives of the City of elm and other governmental agencies to enter upon and inspect
said propertla~3'~r~ason bly necess ry to cess this application.
~~;~ ~ ~ -- ~f~~~~
Signe , ~'~ -~ ~~ ~~ ~ ~ Date ~ /
ROUTING: SPECIAL EVENT Building Section
TEMPORARY USE Planning Section Building Section
105 Yelm Auenue West
PO Box 479
Yelm, WA 98597
(360) 458-3835
(360) 458-3144 FAX
www.ci.yelm.wa.us