20100180 Permit Package 083012 _
�o�rHFp� City of Yelm Permit No.: 20100180
4 �
� Community Development Department Issue Date: 08/30/2012
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
L
«..��«�ro� Fax: (360)458-3144
Applicant:
Name: KEVIN DOWNEY Phone: 400-2323
Address: 213 YELM AVE.WEST
YELM WA 98597
Property Information:
Site Address: 213 YELM AVE W Owner: KEVIN DOWNEY
Assessor Parcel No.: 85800300600 Subdivision: Lot:
Contractor Information:
Name: KEVIN DOWNEY Phone:
Address:
213 YELM AVE.WEST
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: SIGN
Description of Work: ONE MONUMENT, 3X8 SIGN
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SIGN KEVIN DOWNEY $ 20.00
TOTAL FEES: $ 20.00
ApplicanYs Affidavit: OFFICIAL USE ONLY
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 #Sets of Prints:
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 Final Inspection:
registered in t e State of Washingtpn.
2 Date:
Signature Date
By:
Firm