20130300 Permit Pkg 08222013 �pF TH�p� City of Yelm Permit No.: 20130300
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4 � Community Development Department Issue Date: 8/22/2013
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
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"""`„'""°" Fax: (360)458-3144
Applicant:
Name: O'RYAN'S SMOKE DBA YELM SMOKE Phone: 360-400-4338
Address: 508 YELM AVE.W.
YELM WA 98597
Property Information:
Site Address: 508 YELM AVE W owner:
Assessor Parcel No.: 21724141202 Subdivision: Lot:
Contractor Information:
Name: O'RYAN'S SMOKE DBA YELM SMOKE Phone:
Address: MARK L. RYAN
508 YELM AVE.W.
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: GRAND OPENING
Sq. Ft per floor: First Heat Type(Electric,Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SE O'RYAN'S SMOKE DBA YELM SMOKE $ 0.00
TOTAL FEES: S 0.00
ApplicanYs 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 regulation including those governing zoning and land subdivision,and in addition,all covenants,
easementS and strictions of record. If applying as a contractor,I further certify that I am currently Final Inspection:
registeretl in th tate of W hington. f
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Signatur Date �t Date:
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Firm ,� �v� ` �`�2:
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Q�o,� TNFa$� City of Yelm
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Community Development Department
SPECIAL EVENT/TEMPORAR Y USE
APPLICATION
YEL
WA6NiNCTON
Special Event Sign Permit(�imited to�4 days,4 times per calendar year)
Telllpot'ary USe (property owner permission letter required)
(see REVERSE for regulations)
NAME OF PROJECT
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APPLICANT/BUSINESS NAME 'IC�
Mailing Add�ess �'1'R ( 1 �l�v�-. ,/k�� � �
City, State and Zi� �' ��'�
Telephone ��-�� �3 EMAIL
City of Yelm Business License Number
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SITE OWNER H�� G-
Mailing Address '�'� �a 3b4=` .�T. Cc�u�ar �
City, State and Zip �N1����� P�- t�.�A
Telephone Z5�- 5�65 5��� EMAIL ?.
SITE ADDRESSlLOCATION
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SITE PARCEL NUMBER �
SUMMARY OF REQUEST
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START DATE�� L END DATE _
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 affirm that I am the owner of the subject site or am duly authorized by
the owner to act with respect ta this application. Further,I grant permission from the owner to any and all
employees and representatives of the City of Yelm and other governmental agenci s to enter upon and inspect
said pro rty as reasonably necessary to process this application.
Signed Date f
ROUTING: SPEGIAL EVENT Building Section
TEMPORARY USE Planning Section Building Section
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105 Yelm Aoenue West (360)45&-3835
pp gox qyg (360)458-3144 FAX
Yelm,WA 98597 ��"`�'�jVED
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; AUG 2 2 2013
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