20110133 Permit Pkg 01272011City of Yelm
Community Development Department
Building Division
Phone: (380) 458-8407
Fax: (360) 458-3144
Permit No.: 20110133
Issue Date: 1!27/2011
(Work must be completed within 180 days)
Applicant:
Name: NATIONAL SIGN CORP
Address: 1255 WESTLAKE AVE
SEATTLE WA 98109
Property Information:
Site Address: KII I ICON R YFI M OVF
Assessor Parcel No.:
Contractor Information
Name: NATIONAL SIGN CORP
Address: MIKE STROPE
1255 WESTLAKE AVE N
SEATTLE WA 98109
Phone: 206-282-0700
Lot:
Phone: 206-282-0700
Contractor License No.: NATIOSC166MS Expires: 3/31/2011
Project Information:
Project: SIGN
Description of Work:
Sq. Ft. per floor:
Fees:
Item
SIGN
Subdivision:
Contractor
NATIONAL SIGN CORP
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 Washing~n. /~
Owner: CITY OF YELM
3-SIDED MONUMENT SIGN DISPLAY WITH 16MM FULL COLOR LED MESSAGE CENTERS.
First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees
$ so.oo
S 60.00
OFFICIAL USE ONLY
Sets of Prints:
final Inspection:
Date:
By: _
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CHRi~GE: i~.0,~
CITY OF YELM 2D `~~ v~
SIGN PERMIT APPLICATION FORM
Pro~ect Address: ~~~~ ~,,,,~,~arcel #: ~~t;l'1 7-OF-I/~ ~` / y~c f~b., 2 171 e J
K N~ Y~ i~~ vc~~F"t ~ 4
Current Use: r° +cy+7o., ~~ Proposed Use: ,~~
Zoning; ~ ~ ~ ~ ~+I J~ ~ ~, u N~
Type/Number ofSign(s)(wall, monument, lighted, etc.): ~ /~'JON~MC~~T S/6NC3) sfs~s
Dimensions of Sign{s): S t~ (~ ~} "~j-/{C H ~r.~
Building Gross Floor Area {sq. ft): /V//~
Building Height: /~~/~
Existing Signage {if any) and dimensions: N/ ~
}IPPL.ICAN`f D V K-u S A A [,
Last Name First Name
ADDRESS P.I) I~J~ 1~QS'`1 EMAIL ISA tO ~ IV~TI~.N~L S Ivn~~o~
CITY L ~ ~ Lr ~ y STATE t/~ZIP Spy TELEPHONE o - -
6UfLUlftlG OWidER (i ? Y O F ~/= LNl
ADDRESS I G' ~ YLS ~M A v~ W EMAIL
CITY ~t/ LM STATE wA ZIP yll~'Y 7 TELEPHONE G~ -`fJ ~' ~~'tol
BUtLt~l~l~'#'~N~-~ ~ l-~t e H M 1 ~ ~ o F ~ cr~t ~-
ADDRESS 70 f~ KID t L */ G EMAIL
CITY ~~-M STATE ZIP ft TELEPHONE 3Ea..~,i 1I ' 6[o.P
SIGN I~PiT1~1~~TQR NAT1 ~7 /'/A L Sl N Cy r2 1~, TELEPHONE 3 G D _ SF S9-rFW ~ 2
ADDRESS I '2. SS- I,/,~7 t_R KoT v~ N EMAIL
CITY S~aTr Lam; STATE L~q ZIP 9~(t,~y FAX ,
~ CONTRACTOR'S UCENSc ~N°~Ti i;"} ~ LC A^_> tXF SATE . ~~ CITY t_!CtNSc#
I hereby certify that the above infor tion is correct and that the construction of the above described sign will be in
accordance w' h the laws, rules a regulations of the State of Washington and the Cityl of Yelm.
~~ l
Appli s Signature D to
Owner /Contractor /Owner's Agent !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 ftx a period of 180 days
S ~ ~ L ~ ~ N~Tit~NAL .S~(~ !~ C~ 2r'. ~~s~-~
Co M
l05 Yelm Acenue West (360) 458-3835
PO Box 479 (360) d58-3144 FAX
Yelm, WA 98597 rumrv.c J~L~II~ ~~ 5~+,- .J
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