20050134 Permit Pkg 012306~
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CITY OF YELM
SIGN PERMIT APPLICATION FORM
ProjectAddress: 1409 East Yelm Ave. Parcel#: 85810000100
Zoning;
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Current Use: Proposed Use:
Type/Number of Sign(s) (wall, monument, lighted, etc.): 2 t^1a 11
Dimensions of Sign(s): 14 ' 11 " 2' 6" x 14 ' 11 "
Building Gross FloorArea (sq. ft): 3, 612-Canopy Area 325 - Gas Hut
Building Height: Canopy - 19' Gas Hut - 12' oniurn~T
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ExistingSignage(ifany)anddimensions: existingvto be removed ~ ~t~g~~
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,s ~ UAN
If Grand Opening Sign(s) (limited to 14 days): Dates: From To
If Special Event Sign(s) (limited to 14 days, 4 times per calendar year):
Dates: From To
Previous Date(s) Displayed This Calendar Year:
BUILDING OWNER Safeway
ADDRESS P.O. Box 85001 EMAIL
CITY Bellevue STATE Wa ZIP TELEPHONE
BUILDINGTENANT Safeway Fuel
ADDRESS 109 E. Yelm Aven EMAIL
CITY vPl m STATE WA ZIP TELEPHONE
SIGN CONTRACTOR P 1 umb S i g n s I n c. TELEPHONE - X
ADDRESS 909 S. 28th St. EMAIL connie p um signs.com
CITY Tacoma STATE WA ZIP 98 ~ FAX ~ -
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE # - •~
PLUMBSI077QS 1
I hereby certify that the above information is correct and that the construction of the above described sign will be in
accordance with the laws, rules and regulations of the State of Washington and the City of Yelm.
~~ 1/23/06
ApplicanYs Signature Date
Owner i Contractor / Owner's Agent / Contractor's Agent / 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
105 Yelm Aueriue West (360) 458-3835
PO Box 479 (360) 458-3I44 FAX
Yelni, WA 98597 www.ci.yelni.wa.us