20130271 Permit Pkg 07162013 �oF iN�'a� City of Yelm Permit ►vo.: 20130271
� � Community Development Department issue Date: 7/16/2013
- (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
'"""'"`�°" Fax: (360)458-3144
Applicant:
Name: FIRST BAPTIST CHURCH Phone:
Address: P.O. BOX 5090
YELM WA 98597
Property Information:
site Address: 602 103RD AVE SE owner:
Assessor Parcel No.: 22730110102 Subdivision: N/A Lot: N/A
Contractor Information:
Name: FIRST BAPTIST CHURCH Phone:
Address:
P.O. BOX 5090
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: VACATION BIBLE SCHOOL, JULY 27 THRU AUG 10, 2013
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SE FIRST BAPTIST CHURCH $ 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 regulatio "ncluding those governing zoning and land subdivision,and in addition,all covenants,
easements and rest ' ions of recorc�. If applying as a contractor, I further certify that I m currently Final Inspection:
registered i�the tat of ashi tqt�. ' ,
�� r � /'
Signature ' � � � � � � ate � � ->—� Date:
� By:
Firm �
���o�,�I
��� T�p�,� City of Yelm
' p�, e
Community Development Department
SPECIAL EVENT/TEMPORAR Y USE
APPLICATION
YELM ,
WASNINGTON �r�� � � /\ �� �� /`
��w Pi l�� ;u ) ��. , i_ k',.' `
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Special Event Sign Permit(�imitea to �4 days,4 times per calendar year)
Temporaly Use (property owner permission letter required)
(see REVERSE for regulations)
NAME OF PROJECT V��'�f`(�� �� �/� �c-G�
APPLICANT/BUS/NESS NAME �� �� � � ��-• j ��-�
Mailing Address /�C� ; �� ��'�� -� . (,v �'
Citv State and Zip � %/ l .� �
Telephone 3��`�.Sy-�7�� 7 EMAIL _ /awe��(t' ;ur�u, c���-
City of Yelm Business License Number
S/TE OWNER S �
Mailing Address
City, State and Zip
Telephone EMAIL
SITE ADDRESS/LOCATION C1" � r'�' S� --�L�� l .-
SITE PARCEL NUMBER
SUMMA Y OF REQUEST , � � � � . �
c� (�j]�G� /1 cv�2 r�
START DATE 1 END DATE � d �P/ �Z
I affirm that all answers, statements and information above and submitted with this application are complete and
accurate to the best of my knowledge. I also irm that I am the owner of the subject site or am duly authorized by
the owner to act with respect to this appli . Further, I grant permission from the owner to any and all
employees and re sentatives of the elm and other governmental agencies to enter upon and inspect
said property a as nably ecess process this application. j �
�/ � �
Signed U/� `�`� Date � ��
ROUTING: SPECIAL EVENT Building Section
TEMPORARY USE Planning Section Building Section
105 Yelm Avenue West (360)458-3835
PO Box 479 (360)458-3144 FAX
Yelm, WA 9859� www.ci.yelm.wa.us