20120192 Permit Pkg 05212012City of YEW
Semiannually Development Department
Building Division
Phone: 100014584401
Fee (860) 455-3144
Applicant
Name'. KEN KERSEY
Address : PO BOX 1119
MCKENNA WA 98550
Permit No P07Y0192
luue Dab: 612RAM12
Monk must he moped wave 100 aapl
Phone: 25;2008409
Property lithographer:
Site Address: IMS YELM AVEE Owner: SQIAK
Swearer Rental NO.: 22130140400 Subhuman: LAK
contractor Information
Name. KEN KERSEY
Address KEN KERSEY
PO BOX 1108
MCKENNA WA 08558
Colledw Romme NS.:
Project lnbrmwE :
Project FIREWORKS
Deamphon of Wak: FIREWORKS STAND
Sc. FL per now: Fla
Second
Third
Dart
no em
Fees:
Item COnhawor
FIRE KEN KERSEY
Phone'.
Edward. W'CUI0000
Neat Type Papers. car. Olherl'.
Feet
0 ]000
RRAL FEES: 0 80.00
App oven's Meadow:
OFFICNL USEONLY
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tote nut am wrre¢I alw mMy Intl ua pmpored structure s In pMwmeny nh all weldable Cry of
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RECV: 000918% 6/11/7012 10:36 AN
OPEN: CO TERN: 001
REEA:
THAN 33.0000 BUILDING PERMITS
201101% 30.0008
KERNEY, KEN
1905 VELA AVE E
FIRE 30.000R
TENDERED: 30.00 CASH
APPLIED: 30.00,
GRANGE: 0,00
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CRY OF YEW
COMMERCIAL BUILDING PERMR MPLICATION EONS
Use:
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Building Area IN pl Penang Garal Floor_Rn0 Floor 3w Floor_
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CONTRACTOR'S LICENSER U
UP DAT CITY LICENSE
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gage DATE CRV LICWSEi
MECHANICAL CONTRACTOR T
TELEPHONE
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CITY STATE ZIP F
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CONTRACTOR'S LICENSE E
EAPOATE CIWLICENSE#
Data
Owner) COMn dMlOwner's c1gent lCOnlractola Agent) Tenant IPleafe clrcb one.)
All germpa an and will nail XwoM authorized by such permit b not begun
within 180 days or iasuancq or XwaNt b eupentleE or aeandoned fora penoE of IN days
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i WA
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f.e WA suss ..MO..yf..w_.�.
TO
FIRE PROTECTION BUREAU
OATS OF
FIREWORKS LICENSING PROGRAM box 4"of
fireworks stand will be located.
Olympb WA 981t o
APpI4w Hvme
(MO)5943914 FAX: (360)5963934
L G S
Or xv
ewv SS
Spoawr(homer Wan apparent)
APPLICATION
Imtba of proposal firmorW stand [EOabre growing of Head location]
FOR RETAIL FIREWORKS STAND PERMIT
OS m e
TO
6ovemingbody of city, town, or cmmsy in which
OATS OF
fireworks stand will be located.
APPLICATION
APpI4w Hvme
Aadmu,C"'Nate
L G S
Or xv
ewv SS
Spoawr(homer Wan apparent)
Aaaeeq Cry, state
Imtba of proposal firmorW stand [EOabre growing of Head location]
OS m e
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FIREWORKS STAND PERMIT
For the Fireworks Sales Year of. ;?O /1
(Must be Conspicuously diaplayed at nil times while the stood is open to We public)
Byvmue of having been granted a license by live Smle or Wasounglon and this permit from
C' % k as the local governing Radorily, the named person, firm or
mgamvtion m hereby authorized to sell U.N. 03361.46 Consumer fireworks at the location
dealgrated herein between the following date and times:
Sales for July Oa
From: S x 2� t 10/2
Fix Tr. �J S 1x12
—
Sponsor
From:
To
Sales for December 31°
Loca4on ✓51 .y r![
Sugmam,'flufflaW Crtaniirm Pmoit /� Slppeme aftAppM1Cmt/
Title %A w s&,K Agency �(t�1' �E ✓�
Date (F • te • ( Permit Number �rL16�u2
Licensee Name License Number
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voce
301
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