20110148 Permit Pkg 03012011City of Yelm
Community Development Department
Building Division
Phone: (360)458-8407
Fax:(360)458J144
Applicant:
Name: OLD SCHOOL TATTOO
Address: 106 YELM AVE W
YELM WA 98597
Property Information
Permit No.: 20110148
Issue Date: 3/01/2011
(Work must be completed within 180 days)
Phone: 360-564-5401
Site Address: 106 YELM AVE W Owner: BUDDY GREEN
Assessor Parcel No.: 85800100100 Subdivision: Lot
Name: OLD SCHOOL TATTOO Phone:
Address:
106 YELM AVE W
YELM WA 98597
Contractor License No.: Expires: 0/00!0000
Project Information:
Project: SIGN
Description of Work: 5 FT X 8 FT MONUMENT SIGN
Sq. Ft. per Floor: First Heat Type (Electric, Gas, Olheq:
Second
Third
Garage __
Basement
Fees:
Item Contractor Fees
SIGN OLD SCHOOL TATTOO $ 20.00
TOTAL FEES: $ 20.00
Applicant's Affidavit: OFFICL4L USE ONLY
I certify that I have read and examined the information contained within the application and know the same
to be true end correU I also certify that the proposed sWClure is in conformity with all applicable Ciry of A Sets of Prinfs:
Yekn regulations including those governing zoning and land subdivision, and in addihon, all covenants,
easements and restndions of record. If applying as ntraUOr, I further certify that I am rrently Final Inspection:
registered in the of Washington
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CITY OF YELM
SIGN PERMIT APPLICATION FORM
Project Address: ~'~~ -!/.r% 1a7 r~i/.r vP~r/ceI #:
Zoning; Current Use:_ _ Proposed Use:
Type/Number of Sign(s) (wall, monument, lighted, etc.): ~ ~ ~ %~~ ~ U / ~ (//77 ~ f't ~~ Sl i1J 11
p i
Dimensions of Sign(s); .5 7 X O I
Building Gross Floor Area (sq. ft): `-
Building Height:
Existing Signage (If any) and dimensions:
RAFLlCAAIT ~ ~/t~~
Last Name First Name
ADDRESS Y EMAIL
CITY STATE ZIP LEPHONE ?' ' - ~ ~j
BUILbING-OWNER ~ . -
ADDRESS ~~~.~.Zt EMAIL
CITY STATE ZIP TELEPHONE
@f j11.DING TENANT
ADDRESS EMAIL
CITY STATE Zlp TELEPHONE
SIGN CONTRACTOR /.. c'C ~ G TELEPHONE
ADDRESS EMAIL
CITY STATE 21p FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
I hereby tartly that the above IMormatlon is Corr9et and that the conaVUCdon of the above descrbed sign well be In
accordance wHh the laws, rubs and reguWtions of the State of Washington and the Ciy of Yelm.
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Applicant's Signatu D' e
Owner /Contractor 7 Owner's Agent /Contractor's Agent /Tenant (Please circle one.)
AlJ permits are non-transferable and will expJre If work authorized by such permit is not begun
within 180 days of issuance, or ff work Is suspended or abandoned for a period of 180 days
!~
r05 Yeim Avenue Nest (860) 458-3835
PU Box 479 (860) 458-3/44 FAX
YeIm,WA 98697 www.ciyelm.wa.ue
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