303 D Creek St CITY O F YE LM OFFICIAL USE ONLY
�O� T�p� � 105 Yeim Ave. W. FEE $35.00
Rec By
4 � Yelm, WA 98597 Comm Dev.D t.
� �. (360) 458-8437 OFFICE Bldg Dept. � � �
'�' (\ (360) 458-4348 FAX �, �. )
Insp.Date
� www.ci.velm.Wc'�.laS Lic.No. � '�_�
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YELM APPLICATION FOR
WASHINGTON BUSINESS LICENSE
Upon receipt of the license application and$35.00 payment, the City of Yelm will conduct an inspection of
the premises for building and fire code conformance. Upon approval from the Yelm Building Department
of said premises,the City Clerk's Office will process the application and mail license to applicant at
add�ess listed below.
Application is hereby made for a Business License for the City of Yelm
� NEW BUSINESS � NAME CHANGE/MAILING ADDRESS CHANGE ONLY
DATE I "'�� 'I.�
BUSINESS NAME �' a i�� .� I ��tGi�' � ���'t"�}��C��2�� � .
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NATURE OF BUSINESS�(�� ��rrL��
BUSINESS LOCATION ADDRESS,��,� .1� Ci�P� ������G�� � -���7
MAILING ADDRESS��sv' I�c'� �� YF'�l�i����'����7
ANTICIPATED OPENING DATE
DAYS 8 HOURS OF OPERATION � � � � � :jt-`� � ��$'
OWNER(S) 1� .t'C���.� (�Irl �
Birthdate �'� � ����_Z_
Address t t���+3 Fi +�,� I ��`i� i�FflY/ l�if� �.���� ��
��� ity State Zip
TELEPHONE ,;�-�j 4C�`� ��i' Y� b�S'�(S�C3 �I(,��L_'�.`�c� �
(Business) ��� ,�j�� �_�.S'�Z (Home/Emergency)
CONTRACTOR'S REGISTRATION NO.
(If applicable)
THURSTON CO. HEALTH APPROVAL NO.
,
STATE OF WASHING N MASTER BU INESS LICENSE NO. (UBI)
,
Signat Date � ` �I� ��
€S' l.J l � �'�" `'' CJ
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Page 1 of 1
�4'V'�s�lulgton State D�pai�nen�. vf Revenue
State Busin+ess Recot•c�s Dat�base Det�il
TAX REGISTRATIQN NO: 603194697 ACCUUMT OPENEQ: 04j01/2012
UBI: 603194697 ACCOUNT CLDSED: OPEN
ENTITY NAME: LEWIS REAL ESTATE 5ALE5 AND PRDPERTY MANAGEME
BU5INE55 NAME: LE14I5 REAL ESTATE
MAILING ADDRE55: BUSINE55 LOCATION:
16843 FLUME RD SE 16843 FLUME RD SE
YELM�WA 985�9T-9626 YELM,'WA 98597-9626
ENTITY TYPE: CORPORATIOM RESELLER PERMIT NQ: N/A
PERMIT EFFECTIYE: N/A
NAICS CODE: 531210 PERMIT E}fPIRES: IV�A
NAICS DEFINITION: OFFICES OF REAL ESTATE
AGEIVT5 AND BROKERS
F�R N�N-C�MMER�IAL USE �NLY
O1J31f20133:18PM
http://dor.wa.gov/images/BRDImage.aspx?tra=OhN/ShzvrUMxvSGCzAZ8Jjh9TpH3yz3... O 1/31/2013
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Public Worl�s DeparCrnerzt
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Yelm, [�A .9b'�.97
YELM
WASHINGTON
Date ��/°���
Property Address: �b � � ���1'���� ���- L� (�,� �� C� �S�I�
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Business License Applicant: �V1��G�. k; ��� ( �[1�15
Dear Applicant:
Section 13.04.220 YMC requires all commercial buildings and irrigation systems to have
a Reduced Pressure Backflow Assembly (RPBA) device installed on the water services.
Installation of a Reduced Pressure Backflow Assembly is required
❑ Prior to approval of your business license
❑ Within days of change of ownership
o pp icable
Contact Kevin Ray, City of Yelm Public Works (360J 458-8410
kevinr(a�ci.yelm.wa.us for details on device options and inspection
requirements.
Fats, oils, and greases entering the City of Yelm STEP sewer system can adversely
affect the operation of the plant and the City requi�es all appropriate measures to avoid
fats, oiis and greases from entering the system. Section 13.08.090 Yeim Municipal
Code requires an appropriately sized grease interceptor to be installed prior to the
STEP tank.
Installation of a Grease Interceptor is required:
❑ Prior to approvai of your business license
❑ Within days of change of ownership
❑ Not Applicable
Contact Jim Doty, City of Yelm Public Works (360) 458-8411
jimd(c�ci.�elm.wa.us for details.