20100190 Permit Pkg 10072010City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: RANDEEZ COFFEE
Address: 4570 AVERY LANE PMB 132
LACEY WA 98503
Permit No.: 20100190
Issue Date: 10!0712010
(Work must be completed within 180 days)
Phone: 360-481-5744
Property Information:
Site Address: ~ QQ$ YELM AVE E Owner: RANDY CHAMBERLAIN
Assessor Parcel No.: 22730110209 Subdivision: Lot:
Contractor Information
Name: RANDEEZ COFFEE Phone:
Address:
4570 AVERY LANE PMB 132
LACEY WA 98503
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: SIGN
Description of Work: TWO WALL SIGNS APPROVED ON CONDITION OF REMOVAL OF UNPERMITTED SIGNS.
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
SIGN
Contractor
RANDEEZ COFFEE
TOTAL FEES:
Fees
$ 40.00
S 40.00
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 ord. If applyi a contractor, I further certify that I am currently
registered in th of hi gton. ~ ^ ~^
Signature Date ~J
Firm
# Sets of Prints:
Final Inspection:
Date:
By:
iii ~y: ~~ j`~~i~i
!iC k r I_!f"Jl;~.'~~ 5: lJ~ ~ '! L! r /rf(?, .J '? t [
,,-,,~,.
ii r)j'1; .~i, f1lj~lt~ Uf J'f! ";"~^ i[[: ~rrt;
_ n_i
C _,,.fr
i ;i_i; 'Y^C hi ~U F
~T~t1
~~-~ r,...f {`
c~ l oa l q t~
2
CITY OF YELM
SIGN PERMIT APPLICATION FORM
Project Address: ~ ~g ~e~~ >~~ Parcel
Zoning; Current Use: Proposed Use:
Type/Number of Sign(s) (wall, monument, lighted, etc.): ~ i ~r~ < ~A~_
r
Dimensions of SIQn(S):
Building Gross Floor Area (sq. ft): ~~ " ~S0
Building Height:
Existing Signage (if any) and dimensions: < <-l
1'~
CITY
~~! ~O 2~.0 ~~ ~
00_230 f . t~
BUILDING OWNER ~~
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
BUILDING TENANT~en:~
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 wl th w rules and re ation he State of Washington and the City of Yelm.
loll /~
Applicant's Signature Date
Owner /Contractor /Owner's Agent 1 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
~c ; `
l
105 Ye1m Avenue West ( 458-3835
PO Box 479 (~0~ 438=3144 FAX
Yedm, WA 98597 www.ci.yelm.wa.us
w~ ~.~
~~ ~
~'g;w ..~~. " ~ ~ ~..
k
f-~
t~
r,;:4r
µs~
#+~
k i.
+y q i
~F ~,
' ~~
~
~ 1 * '~
,g +
r
a
~ ~
t
y~z.
tl ~ ~~ aax~ ~
~ ~ ~. ~"~
~ Y
r
.~
L s, n ,
~
~~ ~ ! ~~
e
.~Y "'j ~ ly
' +~ '~
# "ro
:K
~JydT~l i
,p
`:
., ;.,
,.
,~~«
t~
r,~
d~~r
~
~#
~.~ ~,j