20050415 Permit Package 120605~oF TyF,- City of Yelm
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Property Information:
Site Address: 15844 104th. Ave SE.
4 ommunity Development Department
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Building Division
Phone: (360) 458-8407
Fax: (360)458-3144
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Applicant:
Name: Jiggens Networks
Address: 16844 104th Ave SE. City: Yelm
Assessor Parcel No. 85840005200 Subdivision
Contractor Information:
Name: Contact:
Address: City:
Contractor License No: Expires:
Project Information:
Project: Jiggens Networks
Description of Work: Wall mounted sign. Flush mounted sign. 2'X2'
Permit No: SIGN-05-0415-YL
Issue Date: 12/06/2005
(Wor k must be started within 180 days)
Receipt No: 39428
Phone: 360-259-2558
State: WA Zip 98597
Lot:
Phone:
State: Zip:
Business License:
Sq. Ft. perfloor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0
Heat Type (Electric, Gas, Other): OTHER
Fees:
Item Item Fee Base Amt Unit Fee Unit Rate No. Units Unit Desc
Building Permit -Other 20.00 0.00 0.00 0.0000 0.0000 51,000
TOTAL FEES: 520.00
Applicants Affadavit:
OFFICIAL USE ONLY
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 # Sets of Prints:
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~he State of WashinGton.~ Final Inspection:
Date
Firm
CITY OF
YELM
P.O. BOx 479
Yelm, WA 98597
360.458-8403
~ RECEIVED
RECEIPT No. 3 9 4 2 8
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RECEIVED FROM DATE REC. NO. AMOUNT REF. NO.
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City of Yelm PAID Permit No: SIGN-05-0415-YL
Community Development Department Issue Date: 12/0612005
~ DE(~ 0 ~ ~nn5 (Work must be started within 180 days)
Building Division
Phone: (360) 458-8407 Receipt No:
I, Fax: (360) 458-3144 CITY OF~YE(;LM
Applicant: ~ ~`7L-O
Name: Jiggens Networks
~ -- Phone: 360-259-2558
Address: 15844 104th Ave SE. City: Yelm State: WA Zip 98597
Property Information:
Site Address: 15844 104th. Ave SE.
Assessor Parcel No. 85840005200 Subdivision: Lot:
Contractor Information:
Name: Contact: Phone:
Address: City: State: Zip:
Contractor License No: Expires: Business License:
Project Information:
Project: Jiggens Networks
Description of Work: Wall mounted sign. Flush mounted sign. 2'X2'
Sq. Ft. per floor: (1st) 0 (2nd) 0 (3rd) 0 Garage 0 Basement 0
Heat Type (Electric, Gas, Other): OTHER
Fees:
Item Item Fee Base Amt Unil Fee Unit Rate No. Units Unit Desc
Building Permd -Other 20.00 0.00 0.00 0.0000 0.0000 51.000
TOTAL FEES: 520.00
Applicant's Affadavit
OFFICIAL USE ONLY
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 cenify that the proposed structure is in conformity with all applicable City of ~ # Sets of Prints:
Yelm regulations including those governing zoning and land subdivision, and in addition, alf covenants,
easements and restrictions of record. If applying as a contractor, I futher certify that I am currently
registered in the State of Washington. Final Inspection:
Date:
Signature Date
-- - By:
Firm
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Computer & Network
Specialists
www. j iggensnetworks.com
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.`'~'~~ '%'~~'~~~,-~:~'~'~~` CITY OF YELM OFFICIAL USE ONLY
-~ .;~ PO Box 479 Fee Rcod.
~• 'f= ~~ Yelm WA 98597 sy
~p~5 ~ ~ (360) 458-3244
-;~. Comm Dev. DegC~~ I ()~
~/ ~~ Bldg Dept. (/N-- i
= YEL `?'~'-I:,~•g. APPLICATION FOR Insp. Date '
BUSINESS LICENSE `~`~"°~
U~on receipt of license application, the Cit~ of Yelm will cdnduct an inspection of the premises for building
and fire code conformance. Upon approval from the Yelm Building Department of said premises, the City
Clerk's Office will process a business license and billing for 535.00 and mail to applicant at address listed
below. License fee is due two weeks after issue date of license.
Application is hereby made for a Business License for the City of Yelm
® NEW BUSINESS ~ NAME CHANGEIMAILING ADDRESS CHANGE ONLY
DATE _~ NOy ZC7p~
BUSINESS NAME ~ ~ C~(~GNS NE'C"W O(L~S
NATURE OF BUSINESS CoMp~ i C2 ~E ~a~~ /wE3 DCStC~ ty /U~V(2AO
BUSINESS LOCATION ADDRESS (~L~~. IQ~~ aY E SG Yc M WA ~~~
MAILING ADDRESS I S ~ y ~ I Oy~~` A YE SC DEL N~ w A 9 ~~
ANTICIPATED OPENING DATE _~ S NoV Ds
DAYS 8 HOURS OF OPERATION _ ~ bq`t'S ~ WC;E ~ ~~ }~)2 . 7l~ t~-V lC 1
2.~ J !6(~
OWNER(S) ~~C.~1
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Birthdate d 6 (VC~~/ ~'b ~
Social Security No. 6{~ - 5 ~ ~ ~'9~~
Address_(_S~St'Iu IOyt`' Au~G SC `~t~M WA q~,~~"
City State Zip
TELEPHONE c~olJ - o~SC{ - o2SS~ ~ 6U - .5~~ ' ~ ~ I
(Business) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO. N/r
(If applicable)
THURSTON CO. HEALTH APPROVAL NO. N
STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI) b ~ ~ 5 51 ~(~~
~oK~' CITY OF YELM
SIGN PERMIT APPLICATION FORM
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Project Address: ~Sg~t~1 ~~'`' A~YC SE Parcel #: ~ r~ `~ O c~ ~ $ L O (9 _ !~~
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• Zoning; Current Use: Proposed Use: 3
o LO
TypeMumber of Sign(s) (wall, monument, lighted, etc.): 1 t1~Al.A_ MQjINTED .~ X Z 2~OS
Dimensions of Sign(s): ~ ~z ~ ,
Building Gross Floor Area (sq. ft): 13b()~ ~F
Building Height:
Existing Signage (if any) and dimensions: 1Jp~
If Grand Opening Sign(s) (limited to 14 days): Dates: From ~[/a To
-T'
If Special Event Sign(s) (limited to 14 days, 4 times per calendar year):
Dates: From N~ To
Previous Oates) Displayed This Calendar Year: NoNI~
BUILDING OWNER
•
•
BUILDING TENANT SAME AS AtiC~E
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
SIGN CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
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 regulatbns of the State of Washington and the City of Yelm.
Applicant's Signature Date
Owner (Contractor /Owner's Agent I 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
]05 Yelm Avenue Weat (360) 458-3835
PO Box 479 (360) 458-3144 FAR
}'elm, WA 98597 m~vrv.ci.yelm.mn.ua