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20120333 Permit Pkg 12282012
�pF�N�A City of Yelm Permit rvo.: 20120333 4 � Community Development Department Issue Date: 12/28/2012 (Work must be completed within 180 days) Building Division Phone: (360)458-8407 L W�fnlIIQiON Fax: (360)458-3144 Applicant: Name: FAIRPOINT Phone: 509-933-7490 Address: P.O. BOX 199 DODGE CITY KS 67801 Property Information: Site Address: 105 SECOND ST SE Owner: FAIRPOINT Assessor Parcel No.: Subdivision: Lot: Contractor Information: Name: CAPITAL SIGN&AWNING Phone: Address: BILL BROAD P.O. BOX 8106 LACEY WA 98509 Contractor License No.: 00056.10 Expires: 12/31/2011 Project Information: Project: SIGN Description of Work: WALL SIGN Sq. Ft. per floor: First Heat Type(Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor Fees SIGN CAPITAL S�GN&AWNING $ 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 restr' ions of record. If applying as a contractor, I further certify that I am currently Final Inspection: registered in the S of hin n. Signature Date �L�2$/« Date: � r � BY: Firm � Cit� of Y�lm (36 ) 456-8402 REC#: OU114406 12/28/7012 11:33 AM OPER: CO TERM: 001 � REF#: 15458 � TRAN: 33.0000 BUILDING F�ERMII�S 2012.0333 20,OOCR FAIRPOINT 105 SECOND ST SE SIGN 20.00CR TENDEREQ; 20.00 CHECK APPLIED: 20.00- CHANGE; O.Oq � i ; ���b 3�� CITY OF YELM SIGN PERMIT APPLICATION FORM c;� Project Address: �� 5 �� �� Parcel#: Zoning; Current Use: Proposed Use: � Type/Number of Sign(s) (wall, monument, lighted, etc.): ( W l4j' `J r��( �L rc �� Dimensions of Sign(s): T � 't �� ' Building Gross Floor Area(sq. ft): � �� i Building Height: f � Existing Signage(if any)and dimensions: APPLICANT Et `� Last Name First Name ADDRESS �'o �� c�SIO�P EMAIL CITY �1� ' STATE i�_ZIP S� TELEPHONE �(o O q � ��o BUILDING OWNER ADDRESS EMAIL CITY STATE ZIP TELEPHONE BUILDING TENANT e �' �p ' o�.t M �c A ;�: ADDRESS U Z �'� EMAIL CITY STATE ZIP TELEPHONE � , �t SIGN CONTRAC,�OR � • I�I TELEPHO E � G C> ADDRESS l0 � � �IOGa EMAIL C�PS` �t �a/�% CITY STATE tttA ZIP c FAX 36c � CONTRACTOR' 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. � _. (L _ �_ � � Applicant's Signature Date 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 for a period of 180 days � --=, ,-�,-_.-,w,;.�.:,�-_ I`-Il�i! 'r�c- �L�-i�+ V , . �� � LL..,,:1 BY:------------------- 105 Yelm Avenue West (360)458-3835 PO Box 479 (360)458-3144 FAX Yelm,WA 98597 www.ci.yelm.wa.us I n � �' „� . � ,�A� '�r , ��h� �. . �;; ��; �I � r �° �J� , �,A���*': < ��k j•h � `' , � ✓�I �,��. �. . x �., ,, �' � �' e �„ � (`�' F�' �� �.' , ��t�� , � '�: �� =���;Y�". `v � �, ��f'�° � �.�� °� ,e� ,. -? '''? 4� ,��'�;' �i aa�� ;y ' y� ���,.. `�� }A - .:°�� y,� . z �r i � , � � � t a°�� ",sr�. � '�� +,.� �, . x � �}1 �,' �iy': �,a. �. � t M� . 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