20120242 Permit Pkg 01092013 _.
� �oF TH�'�� City of Yelm Permit ►vo.: 20120242
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� � Community Development Department Issue Date: 1/09/2013
(Work must be completed within 180 days)
j Building Division
I Phone: (360)458-8407
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i '"""'"`T°" Fax: (360)458-3144
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Applicant:
�� Name: DREAMTIME Phone: 360-458-7183
� Address: PO BOX 2324
� YELM WA 98597
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Property Information:
Site Address: 109 YELM AVE E Owner: GREGORY PLATT
Assessor Parcel No.: 64400500401 Subdivision: Lot:
Contractor Information:
I Name: DREAMTIME Phone: 360-458-7183
Address:
PO BOX 2324
YELM WA 98597
Contractor License No.: A10559513 Expires: 12/31/2013
'�.
Project Information:
Project: SIGN
Description of Work: WALL SIGN 85.22 IN X 41.37 IN
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SIGN DREAMTIME $ 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 the State of Washington.
Signature Date �
� Date:
�
Firm BY'
,
�
City of Yelm
(360) 458-8402
REC#: 00115588 1/09/2013 10:38 AM
OPER: CO TERM: 001
REF#: 15659
TRAN; 33.OG00 BUILqING PERMITS
20120242 20.00CR
DREAMTIME
109 YELM AVE E
SIGN 20.00CR
TENDERED; 20.00 CHECK
APPLIED: 20.0�-
CHANGE: + � 0.00
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C� O Q��
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CITY OF YELM
SIGN PERMIT APPLICATION FORM
Project Address:�/V ( ��`1'L1 ` " �� � Parcel#:
Zoning; �� �� Current Use: ����a � Proposed Use: `��"�-�
Type/Number of Sign(s) (wall, monument, lighted, etc.): ����
�� � �_ � � _T'
Dimensions of Sign(s): �J' �� �� � �� ��(
Building Gross Floor Area (sq. ft):
Building Height:
Existing Signage(if any)and dimensions: —
APPLICANT ' r' 2� — �
La t Name ---First Name
ADDRESS �° �� < ��✓�✓ ' �/ EMAIL
CITY N'�I STATE r'+//1 ZIP ELEPHONE c"�
BUILDING OWNER
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
__�
BUILDING TENANT � L n � C
ADDRESS i� { /�l �' EMAIL
CITY ' STATE Gt//�- ZI ELEPHONE �-- cX7 2�
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SIGN CONTRACTOR � � / TELEPHONE %'
ADDRESS —� �- '� MAIL
CITY STATE �it¢- ZI " FAX
CON ACTOR'S LICENSE# EXP DATE CITY LICENSE#
I hereby certify that the above information is correct and that the construction of the above described sign wiil be in
accordance with the laws,rules and regulations of the State of Washington and the City of Yelm.
_ ;��-�.�����
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
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105 Yelm Avenue West (360)458-3835
PO Box 479 (360)458-3144 FAX
Yelm,WA 98597 www.ci.yelm.wa.us
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