20130187 Permit Pkg 05032013 o �'� City of Yelm Permit ►vo.: 20130187
,� Community Development Department Issue Date: 5/03/2013
4 (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
""''"'""°" Fax: (360)458-3144
Applicant:
Name: YELM LIQUOR&BEVERAGE Phone: 360-4014
Address: 1110 YELM AVE E
YELM WA 98597
Property Information:
Site Address: 1110 YELM AVE E Owner:
Assessor Parcel No.: Subdivision: Lot:
Contractor Information:
Name: YELM LIQUOR& BEVERAGE Phone:
Address:
1110 YELM AVE E
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: SPECIAL EVENT RUNNING FROM 5-3-2013 TO 5-16-2013
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SE YELM LIQUOR&BEVERAGE $ 0.00
TOTAL FEES: $ 0.00
Applicant's 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. �f applying as a contractor, I further certify that I am currently Final Inspection:
registered in the State of Washington.
Signature Date Date:
Firm BY'
05/03/2013 FRI 13:52 iR C3480 �001
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*** TX REPORT ***
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JOB NO. 2834 �CJ��
ST. TIME 05/03 13: 52
PGS. 1
SEND DOCUMENT NAMF
TX IMCOMPLETE -----
TRANSACTION OK -----
ERROR \\yelmdataserver\cdd data Incoming FAX
May 03 13 02:04p p.1
ow�� T��$.� C'i�y a f �'elm
- 4 �
C'omm�nity �evelopment Departmen�
SF,EG'IA�L EVENZ'I T.E1t1.FC)RARY USE
APPLI�'ATION
YE L1VI
WASNiNGTON
� SpeCial Event Sign Rermit(limited to 14 days,4 times per calendar year}
Tempor�ry Use {property owner perrnission letter required)
{see REVERSE#or regulations)
NAME OF PROJECT
AFPLlCANT/BUSlNESS NAM�E
Maifing Address J l ld � ` � l7
City, State and Zip � G3
Telephpne 1 EMAiL ' �
City of Yetm B�sin�ss License Number
-- S1TE OWNFR
Mailing Address
City, State and �ip
�elephon� EMAIL
SITE ADDRESS20C,4TlON
SITE PARGEL 11tUA98ER
SUMMARY O�REQU�ST
START DATE ,��-i-'?��7D�� EIVD DATE "'�
i a[firm that all answers,statements and information above and submiited with this a}�plication are complete and
accurate to the best of mu knowledae. I also affirm that! am the awner of the subiect site or am duly authorized by
May 03 13 02:04p p.1
a��� T��$,� Ci�y af �elm
- a n�
Comrnunity .lJ►evelo�ment Department
SPECIAI, EVE�V'2'/T.EM�'��AR Y USE
APP�I CA�''�'U�V
YELM
was..�.�.o*aa
� SpeClal EVent Sign Permit(limited to 14 days,4 times per calendar year}
Ten'�pOrary Use (property owner permission letter required)
{see REVERSE for regulations)
NAME OF PROJECT
AFPLIGANT/BUSINESS NAME
Mailing Address 1 i 1Ca ��` � 11 `J
City, State and Zip � c3 9'
Telephone 1 EMAIL ' � `
City of Yelm Business License f�umber
- SI TE OWNFR
Mailing Address
City, State and Zip
Telephone EMAIL
SITE ADDRESSlLOC,4TION
SITE PARCEL NUMBFR
SUNINIARY OF REG?UEST
START DATE R-i-?��1,y.�_ END DATE' �'`
1 affirm that all answers, statements and information abo�e and submiited with this a�plication are complete and
accurate to the best of my knowledge. I also affirm thai! am the awner of the subject site or am duly authorized by
the owner to act with respect tv this appl�cation. �urther, I grant perrr�issio�from the owner to any and all
empioyees and representatives o City ot Yelm and okher governmental agenaes to enter upon and inspect
said property as reasonabl sa Ehis application.
Signed ate � ;� `-6 �
ROUTING: SPECIAL EVENT Building Sectian
TEMPORARY USE Planning Section Building Section
10v Y'elm.4cenue YL'est (360)4�8-3835
PO Box 478 (360)458-3144 FAX
Yelm, W_4 885J7 uraw.ei�velm.wa.�s