201 Yelm Ave E (2) C ITY O F YE LM OFFICIAL USE ONLY
�O� TH�A� � 105 Yelm Ave. W. FeE $35.00
Rec By
�Q ,� Yelm, WA 98597 Comm Dev.Dept.
4 � (360) 458-8437 OFFICE Bldg Dept. � ' S 1�
(360) 458-4348 FAX Insp.Date
� www.ci.yelm.wa.us
Lic.No.
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YELM APPLICATION FOR �
WASNINGTON BUSINESS LICENSE � ..��
Upon receipt of the license appiication and $35.00 payment, the City of Yelm wili conduct an ins 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
address 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 .— 7iO (�
BUSINESS NAME � rC'� ���1'I l_..�-. �---
NATURE OF BUSINESS �I t-2�flc��'/�(f'�'2 �1(;j�� ` ' s�,�L�
BUSINESS LOCATION ADDRESS Q I ��' ����J� ��-1.t�C
MAILING ADDRESS 1 ( J 2 '� �'I�ai �A�_ � 7. �L Z���'YJO+�r �Wd � ����
t
ANTICIPATED OPENING DATE
DAYS� HOURS OF OPERATION � �� c-(�ou;_� �'�,v'�-�. + �. �I �-�v .,�'.�',�
E
OWNER(S) t b�l i`1I l+t,�,i� +�Gf �.,,r'�'t��'"�
Birthdate � Z - � � � i �.��F-
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, �`
Address r I � L�� _D§��f�(e �? : S C �(��l►UOrct 'W'b'i ���i ��
City State Zip
TELEPHONE � �'1 � 5�.� __ 7 L�Cl�
(Business) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO.
(If applicable)
THURSTON CO. HEALTH APPROVAL NO.
STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI) � ` �v
Signature - Date b_�— �( .— I �
Page 1 of 1
��`�AS�1lIl�tOI1 S�atC D�jJAI'tIYl4ilt Of RBVellile
�tate B�usiness Recor•ds Dat��ase D�etail
TAX REGISTRATION N0: 603256257 ACCOUHT UPENED: 01/O1/2013
UBI: 603255257 ACCOUNT CLQSED: OPEM
ENTITY NAME: PHO YELM LLC
BUSINESS NAME:
MAILING ADDRE�S: BU5INE55 LOCATIQN:
11329 PRAIRIE CT SE 201 E YELM AVE FL i5T
OLYMPIA�WA 98513-9247 YELM,WA 98597-7662
ENTIT'f TYPE: LIMITED LIABILITY RESELLER PERMIT MO: A27 5913 15
PERMIT EFFECTIYE: 02JOS f 2013
NAICS CODE: 722511 PERMIT EXPIRES: 02/07/2015
NAICS DEFINITIOIY: FULL-SERYICE RESTAURANTS
F�R NUM-C�MMERCIAL USE�NLY
03 f 11/2013 4:46 PM
http://dor.wa.gov/images/BRDImage.aspx?tra=t3 TGRsQKwTfmUoPn 1 E+OuanSy/IApG... 03/11/2013
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4 �ef
Pu�blic Wor�ks Department
IOi Yelm Auenue 66cst
Yelnt, WA ,98597
YELM
W4SHINGTON
Date ����-�3
Property Address � � �% � .
Business License Applicant L�j � • ��,�L� � �-S(✓y�I�t-T+-�
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
❑ Not Applicable
Contact Kevin Ray, City of Yelm Public Works (360) 458-8490
kevinr(a�ci.�elm.wa us for details on device opfions 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 requires ail appropriate measures to avoid
fats, oi!s and greases from entering the system. Section 13.08.090 Yelm Municipal
Code requires an appropriately sized grease interceptor to be installed prior to the
STEP tank.
Installation of a Grease Interceptor is required:
�rior to approval of you� business license C,.,�� �,��(2-��
❑ Within days of change of ownership
❑ Not Applicable
Contact Jim Doty, City of Yelm Public Works (360) 458-8411
Lmd anci.�elm wa us for details.