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20090206 Permit Pkg 100509City of Yelm Community Development Department Building Division Phone: (360)458-8407 Fax: (360) 458-3144 Applicant: Name: EMANUEL LUTHERAN CHURCH Address: 206 THIRD ST SE YELM WA 98597 Property Information: Site Address: 7(1R RRI~ STREET SF Assessor Parcel No.: 64420800100 Contractor Information: Name: EMANUEL LUTHERAN CHURCH Address: 206 THIRD ST SE YELM WA 98597 Contractor License No.: ~ Project Information: Project: OTHER SPECIAL EVENT Description of Work: BIZZARE BANNER OCTOBER 9 - 10, 2009 Sq. Ft. per floor: First Heat Type (Electric, Gas, Other): Second Third Garage Basement Fees: Item SE Contractor EMANUEL LUTHERAN CHURCH 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 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 Firm Permit No.: 20090206 Issue Date: 10/05/2009 (Work must be started within 180 days) Phone: 360-458-3861 Owner: Subdivision: Lot: Phone: Expires: 0/00/0000 Fees $ o.oo $ 0.00 ONLY # Sets of Prints: Final Inspection: Date: By: Zoo~o ~~ 4 ~~ THFp~~~ Ci ty o f Ye lm Community Development Department SPECIAL EVENT /TEMPORARY USE Y E L M APPLICATION WASHINGTON Special Event Sign Permit (limited to 14 days, 4 times per calendar year) Temporary USe (property owner permission letter required) (see REVERSE for regulations) \`^ •U\ ~1 'V NAME OF PROJEC ~,~,~'~ ~''~ `~.~ Ste. cd~ ~d ~ /J APPLICANT/BUSINESS NAME Mailing Address ~?~~~h~ S f- City, State and Zip_ ~, j ,~ f ~~ ~ Telephone MAIL City of Yelm Business License Number S/TE OWNER ~ G e '` ,I. ~ Mailing Address City, State and Zip Telephone EMAIL SITE ADDRESS/LOCATION SITE PARCEL NUMBER SUMMARY OF REQUEST /' " START DATE rC~~- ~-U ~ END DATE l~ ~O-O',q 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 Yelm and other governmental agencies to enter upon and inspect said property as re onably necessary to process this application. J ! c Signed ~Qi Date ~.~ Jr ~~ ROUTING: SPECIAL EVENT Building Section TEMPORARY USE Planning Section Building Section 105 Yelm Avenue West PO Box 479 Yelm, WA 98597 (360) 458-3835 (360) 458-3144 FAX www.ci.yelm.wa.us