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20100202 Permit Pkg 10212010City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: {360) 458-3144 Applicant: Name: OLD SCHOOL TATTOO Address: 106 YELM AVE W YELM WA 98597 Property Information: Site Address: 106 YELM AVE W Assessor Parcel No.: 85800100100 Subdivision: Contractor Information: Name: OLD SCHOOL TATTOO Address: 106 YELM AVE W YELM WA 98597 Contractor License No.: Project Information: Project: OTHER SPECIAL EVENT Description of Work: EVENT BANNER USING FOUR SPECIAL EVENT'S IN A ROW. OCT 19 THRU NOV 2, 2010 NOV 3 THRU NOV 17, 2010 Sq. Ft. per floor: First Second Third Garage Basement Fees: Item SE Heat Type (Electric, Gas, Other): Contractor OLD SCHOOL TATTOO 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 registered in the State of Washington. Firm Permit No.: 20100202 Issue Date: 10!21/2010 (Work must be completed within 180 days) Phone: 360-584-5401 Owner: OLD SCHOOL TATTOO Lot: Phone: Expires: 0/00/0000 Fees $ 0.00 s o.oo OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: ~b~ bC~ Z~ 2 City of Yelm Community Development Department SPECIAL EVENT / TEMPORAR Y USE APPLICATION Special Event Sign Permit (limited to 14 days, 4 times per calendar year) Temporary Use (property owner permission letter required) (see REVERSE for regulations) .J • NAME OF PROJECT APPLICANT/BUSINESS NAME !J ~G ~ ~~ ro Mailing Address i ~~m ~-~ City, State and Zip Telephone ~ ~- ~'- o l EMAILGrr C ~ City of Yelm Business License Number ~ ~ - ~ SITE OWNER Mailing Address I ~ ~ 2 2 S S-~ City, State nd Z' ~ ~ Telephon - g ~` EMAIL SITE ADDRESS/ OCATION f~ ~ `- /~'~ ye (~. Au e, W S/TE PARCEL NUMBER SUMMARY OF REQU~ ~~. /~~~ G/jp - //~ /D .~ ~ - ~ O - /D - ~ START DATE _ END DATE 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 reasonably necessary to process this application. Signed Date ROUTING: SPECIAL EVENT Building Section TEMPORARY USE Planning Section Building Section 105 Yelm Auenue West PO Box 479 Yelm, WA 98597 (360) 458-3835 (360) 458-3144 FAX www.ci.yelm.wa.us ~fa~'/'~