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20100011 Permit Pkg 012210City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360)458-3144 Applicant: Name: SUNBIRDS SHOPPING CTR Address: 1757 N NATIONAL AVE CHEHALIS WA 98532 Property Information: Site Address: 1000 ALGIERS DR NE Owner: Assessor Parcel No.: 99002044532 Subdivision: Contractor Information Name: SUNBIRDS SHOPPING CTR Address: 1757 N NATIONAL AVE CHEHALIS WA 98532 Contractor License No.: Permit No.: 20100011 Issue Date: 1/22/2010 (Work must be started within 180 days) Phone: 360-748-3337 SUNBIRDS Lot: Phone: Expires: 0/00/0000 Project Information: Project: OTHER SPECIAL EVENT Description of Work: SUNBIRD COUPON BOOK STARTING JANUARY 19, 2010 THRU FEBRUARY 1, 2010 Sq. Ft. per floor: First Heat Type (Electric, Gas, Other): Second Third Garage Basement Fees: Item SE TOTAL FEES: AMOUNT PAID: BALANCE DUE: 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 appligble 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 registered the of W s ington. ('~ ~~(,~ ( 1_ Suture ~~~~ .{4N XIl1M-'/~~ 7 Date ~ ~ZZ~J Contractor SUNBIRDS SHOPPING CTR Fees $ 0.00 S 0.00 S 0.00 S 0.00 # Sets of Prints: Final Inspection: Date: Firm I "~ 2v~oc~l City of Yelm Comirrcr~nity Development Department S.l°ECIAL EVEN2" / TEMPORAR ~' USL~" API'I,I CATION Special Event Sign Permit (Ilmited to 14 days, 4 times per calendar year) Temporary USe (property owner permission latter required) (s®e REVERSE for regulations) NAME OF PROJECTS ~~~,j~.f~ C~ ~-~ ~~ :K APPLCANT/BUSINESS NAME ,J6 7~ Mailing Address City, State and Zip - v~ Telephone S EMAIL - ~ •% City of Yelm Business License Number-~a2„ 9.0 SITE OWNER Mailing Address Pn~Rrnt 2~~'9 City, State and Zip 7' Telephone~L~ 4t~S~5 .~9 EMAIL ~! ,~ SITE ADDRESS/LOCATION ~ /~ l~Q. ~~.~, ~/~~J SITE PARCEL NUMBER SUMMARY OF REQUEST ~' r' -.~- -. START DATES A^f ! `i , ZOJD ~ END DATE b,,~ra'S I ~~l0 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 sits or am duly authorized by the owner to aet with rasp®ct to ~ application. Further, I grant permission from the owner to any and all employees and repress tatJves the City Of Yelm and oth6r governmental agencies to enter upon and inspect said p as s y a ry to process this application. ~~// Sign Date . ~- 2+~' ~~ ROUTING; SPECIAL EVENT Building Section TEMPORARY USE Pltlnning Section Building Section 105 Yelm Avenrea Wrbt (860) 45t3-3835 PO Bar 479 (360) 458.9144 FAX Yelm, WA 98b97 wtau.ci.yelm.wa.us 10/10 39tld VJ731.-QbISNIIS IZEZSSb09Ei ib~TT 6i0Z/ZZ/i0