20100206 Permit Pkg 11042010City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Applicant:
Name: JOHN L SCOTT
Address: 106 PLAZA DR NE, STE B-1
YELM WA 98597
Property Information:
Site Address: 1 f1R PI 07~ I'IR NF R
Permit No.: 20100206
Issue Date: 11/04/2010
(Work must be completed within 180 days)
Phone: 360-561-7931
Owner: JOHN L SCOTT
Assessor Parcel No.: Subdivision:
Contractor Information:
Name: ESCO PACIFIC SIGN
Address:
627 N.W. MIDDLE ST.
CHEHALIS WA 98532
Contractor License No.: ESCOPS1233N
Project Information:
Project: SIGN
Description of Work: TWO SIGNS - 2.5 FT BY 5 FT AND 4.5 FT BY 9 FT
Sq. Ft. per floor: Heat Type (Electric, Gas, Other):
First
Second
Third
Garage
Basement
Fees:
Item Contractor
SIGN ESCO PACIFIC SIGN
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. 1 also certify that the proposed structure is in conformity with all applicable City of
Yelm regulations including those governing zoning and subdivision, and in addition, all covenants,
easements and re~'ctions of record. If applying as a ontr or, I further certify that I am currently
registered intJ,ie a of Washington.
Date
Firm
Lot:
Phone: 360-748-6461
Expires: 12/31 /2009
Fees
$ 40.00
E ao.oo
# Sets of Prints:
Final Inspection:
Date:
By:
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CITY OF YELM
SIGN PERMIT APPLICATION FORM
Project Address: ~ ~~!" ~ t Z IJ' ,'f Z-' ) ' 1 P rcel #:
Zoning; ~ L' 1 ~ti Current Use: ~ '! •' ~ ' a' + ~ ~Tp'roposed Use: -~i°-ti1 t'~
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Type/Number of Sign(s) (wall, monument, lighted, etc.):. ~ CL~ . ~t~,:[ l
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Dimensions of Sign(s):~i r'y ti ~ `~ ~-~' ' ~ ~ ~
Building Gross Floor Area (sq. ft): ~ ~ ~ ` ~ ~~'+
Building Height: ~ ~~_' G' )^~I ~ ,~ Y ~~ ~ ~~
Existing Signage (if any) and dimensions: ~~ ~ ~'y'~ !`/
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APPLICANT ' ~ 1C~ '~'C 1'1
L t me j First Name ~ I r
ADDRESS ~ - ~ '~ t'' P - >' _ EMAIL Ys: - ~~~ ~~' ,;~ ~ L 1 .
CITY STA E - , ~ . ZIP ~ " r ~ ` TELEPHONE - ~~ ~- >
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BUILDING O NER ' ~ I '" i' ~~ ' ~ ~~'' ~'- 7 1^ [..~
ADDRESS ~ 7~ ~ i~ EMAIL
CITY ~ "! STATE IP " t TELEPHONE_~ '~, i& 17 ~ !
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BUILDING TENANT -1~,. I I t ` -
ADD SS '1 t- _ E AIL 'rr r ~-~r ~ ~, ..~. 1r1 ~'~G--~ --
CITY "~~ ~ 1, STATE~I.':+ ZIP l'~'~'~ TELEPHONE 1 ";~ j'~t '
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SIGN CONTRACTOR ~ ' r! 1 ~L. ,> i h~ TELEPHONE ~~ ~
ADDRESS :>" ~ f 5 EMAIL '
CITY ~ STATE ~ ZIPS ` • FAX •"' °G' 2s '
CONT ACTOR'S LICENSE # ["Tl c'- EXP DATE CITY LICENSE # -c1 ~, I t'
I hereby certify that the above information is correct and that the construction of the above described sign will be in
accorda a with the laws, rules and regula ' s of the State of washington and the City of Yelm.
~~~ ~` ~~
Applicant's Signature Date
Owner /Contractor /Owner's Ag /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
APPr~OV~D
105 Yelm Avenue Weat
PO Box 479
Yelm, WA 98597
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B Y: ------------
(360) 458-3835
(360) 458-3144 FAX
www.ci.yelm.wa.us
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