15425 Mosman Ave SW (2) C I TY O F YE L M OFFICIAL USE ONLY
��� TNFp�� � 105 Yelm Ave. W. FEE $35.00
'���� 9,� c�; Yelm, WA 98597 CommyDev.Dept.
4 � �, (360) 458-8437 OFFICE Bldg De� �
� (360) 458-4348 FAX Insp.Date
www.ci.yelm.wa.us
Lic.No.
YELM APPLICATION FOR
WASHINCTON BUSINESS LICENSE
Upon receipt of the license application and $35.00 payment, the City of Yelm will conduct an inspection of
the premises for building and fire code conformance. Upon approval from the Yelm Building Department
of said premises, the City Clerk's Office wiil process the application and mail license to applicant at
address listed below.
Application is hereby made for a Business License for the City of Yelm
,
NEW BUSINESS L� NAME CHANGE/MAILING ADDRESS CHANGE ONLY
DATE � -`Zy��.-�
BUSINESS NAME �����., S �5�,� � �r � �j�`,��
�
NATURE OF BUSINESS !►-t-s 1��� ���
BUSINESS LOCATION ADDRESS _I S�I2S I7U5,�-►c., AvY- S�.J
MAILING ADDRESS r�
ANTICIPATED OPENING DATE Uun I
DAYS 8� HOURS OF OPERATION �� ` .�u� JOS„� — 2�•�
OWNER(S) _ /pr-� ��„ z.
Birthdate �- L - (�
Address _ l.7��Z.� �a5�av. ./��t ��✓ (-t �,.� �/./�- �7�5`�l �
/ �, City State Zip
TELEPHONE �Q�` -��S-�� �f
(Business) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO. �--
(If applicable)
THURSTON CO. HEALTH APPROVAL NO. _ i '� - ��}5 Z�
STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI) �03 267 ���
_---��""��
Signature Date ,�'-/�i- /1
Page 1 of 1
�Vashutgton State Dep�artment of Revenue
State Business Recards Data�ase I�et�il
TAX REGISTRATION NO: 603267896 ACCOUNT OPENED: 03J01/2013
UBI: 603267896 ACCOUNT CL05ED: OPEN
ENTITY NAME: COCKTAII ENTERPRISES INC
BUSINE55 NAME: CADDYSHACK B�#R&GRILL
MAILING ADDRESS: BUSINE55 LOCATIOlV:
15425 MOSMAN AYE SW 15425 MOSMAN AVE SW
YELM,WA 98597-7715 YELM,WA 98597-7715
ENTITY TYPE: CORPORATION RESELLER PERMIT NO: A28 284$ 15
PERMIT EFFECTIVE: 05/14/2U1$
NAICS CODE: 722511 PERMITEXPIRES: 05/13/2015
NAICS DEFINITION: FULL-SERYICE RESTAURANTS
F(�R N�N-�(�M M ERCIAL USE (�N LY
05 f 29/2013 4:55 PM
http://dor.wa.gov/images/BRDImage.aspx?tra=tl Yc+Nk78NLBbEfI,Khs006YS85uce 1 A... OS/29/2013
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Public LVorhs De���crl nz�c�n t
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YELM
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Date _ ;,.('���
Property Address ( s�{�-� ��,57Y�t� �-y� S �J '
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Business License Applicant: �p� �)� _� �����.���'}�Q(�_�������
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Dear Applicant
Section 13.04.220 YMC requires all commercial buildings and irrigation syster��s to have
a Reduced Pressure Backflow Assembly (RPBA) device installed on the water services.
Installation of a Reduced Pressure Backfiow Assembly is required
❑ Prior to approval of your business license
❑ � hin days of change of ow hip
��"Not Applicable -
Contact Kevin Ray, Cify of Yelm Public Works (360) 458-8410
kevinr(cr�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 requires all appropriate measures to avoid
fats, oils and greases from entering the system. Section 13.08_090 Yelr�i fViunicipal
Code requires an appropriately sized grease interceptor to be installed prior to the
STEP tank.
Installation of a Grease Interceptor is required: •
��ior to approvai of your business license
cd�P� P�,�����.
❑ Within days of change of ownership �/���3
❑ Not Applicable
Confacf Jim Doty, City of Yelm Public Works (364) 458-8411
jimd(a�ci,yelm.wa,us for details.