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20110121 Permit Pkg 01142011City of Yelm Community Development Department Building Division Phone: (360) 458-8407 Fax: (360) 458-3144 Applicant: Name: KATHIE BENNETT Address: 16200 159TH LN SE YELM WA 98597 Property Information: Site Address: '~f1~ ~IRRT ST S Assessor Parcel No.: 64420200100 Subdivision: Contractor Information: Name: DREAMTIME Address: PO BOX 2324 YELM WA 98597 Contractor License No.: A10559513 Project Information: Project: SIGN Permit No.: 20110121 Issue Date: 1/14!2011 (Work must be completed within 180 days) Phone: 360-894-7295 Owner: ICATHIE BENNETT Expires: 12/31/2013 Description of Work: ILLUMINATED PLASTIC SIGN FACE Sq. Ft. per floor: First Heat Type (Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor Fees SIGN DREAMTIME $ 20.00 TOTAL FEES: S 20.00 Phone: 360-458-7183 OFFICIAL USE ONLY Sets of Prints: final Inspection: Date: Lot: 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 ~i t~ a f - ~Irr U i, 0a E~. COr'~0~,~1 , 1f14f~011 10:;1 Alf r~'EF~: tIC TER?. 401 TR~iH: ;i~,4(Jr7~~ BUII_DI"#t; ,~EE`hiITS ~41I41~1 ~0.4r)~;~' NENr~ETT. K.RTNIE ~4:~ FIF;sr cr s SIr,-t# /~ ?0.44CIC' ~4=44- l D l a,~ ~~ CITY OF YELM SIGN PERMIT APPLICATION FORM • Project Address:3U3 ~ ~~ ~ S 0 • U~ i ~ ~ Parcel #: Zoning; ~~;;,~,fim %r ~iT(k ~ Current Use: ~ Proposed Use: ~ 1~1Q~ Type/Number of Sign(s) (wall, monument, lighted, etc.): cY ~~ (A ~-~~~ ~ ~I ~~ /7 ~~ Dimensions of Sign(s):,,C. X I (2 Building Gross Floor Area (sq. ft): ~ n~ Building Height: rr}}, l„ ~~ Existing Signage (if any) and dimensions: oC `1 Last Name • C, CITY-(,( vn STATE I,Ji~ ZIP 9R S'~i 7 TELEPHONF ~c r~ -- sr ~. ~ BUILDING OWNER ~ r"o ~~ l o V~ L r- ADDRESS. ,'~- vim, I ~-{- `•7-1- ~ t7 ~ EMAIL CITY l STATE~C _ZIP B~~I TELEPHONE X53 ~ 3~6' l~ ' LG a~ .c BUILDING TENANT Gik~ l -~ ~n ~1 ~-E-4- ADDRESS Llr ~ -~.~h L_rt ~ EMAIL CITY STATE tJ,~ ZIP ~-t~55{t-7 TELEPHONE SIGN CONTRACTOR r ~ TELEPHONE_3bD -NS6 -- ~IH 3 ADDRESS ~ I ~_, ~-~ m l~V L ~ . EMAIL CITY STATE W ~~ ZIP G ~S~ "1 FAX CONT CTOR'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 regulations of the State of Washington and the City of Yelm. Applicant's Signature Date Owner !Contractor /Owner's Agent /Contractor's Agent / enan (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 l05 Yelm Avenue West PO Box 479 Yelm, WA 98597 _ . ,. , ~;, 1- ~,/i. www.Ci.yelm.wa.us ~TH~ARBE~. SH O P, s ~~~~~ ~~ F I L ~: ...:. B Y: ___