20130367 Permit Pkg 12182013 if'o� rH�A,p`�' City of Yelm Permit No.: 20130367
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� � Community Development Department Issue Date: 12/18/2013
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
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"»'""°" Fax: (360)458-3144
Applicant:
Name: WINDEMERE Phone:
Address: P.O. BOX 1257
YELM WA 98597
Property Information:
site Address: 709 YELM AVE E owner:
Assessor Parcel No.: 22730120100 Subdivision: Lot:
Contractor Information:
Name: WINDEMERE Phone:
Address:
P.O. BOX 1257
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: SIGN
Description of Work: ALTERNATION OF CURRENT MONUMENT SIGN
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SIGN WINDEMERE $ 20.00
TOTAL FEES: $ 20.00
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 regulations including those governing zoning and land subdivision,and in addition, all covenants,
easements and restrictions of record. If applying as a contractor,I further certify that I am currently Final Inspection:
registered in e State of W shingto
Signature Date Z �'�� � Date:
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CITY OF YELM
SIGN PERMIT APPLICATION FORM
Project Address:��/�L/'� A1/�� �� Parcel#:
Zoning; C 6NL !� Current Use: Proposed Use:
Type/Number of Sign(s) (wall, monument, lighted, etc.): M D�1�M��v1'
Value of each Sign: 2 t 6 b(�
DimensionsofSign(s): ) � 8 �����V%���� ���✓�7k IT;9����
Building Gross Floor Area (sq. ft): Z Z 00
Building Height: � S�i���
Existing Signage (if any) and dimensions: �� x �
APPLICANT G'il_�;�✓(: S�k".✓�
Last Name First Name
ADDRESS O��C lZ r7 EMAIL S�r�=��`(�- % y9D � `�j�%
CITY �/�L r�1 STATE ZIP TELEPHONE 7 - "2
BUILDING OWNER �i4�1 L
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
BUILDING TENANT S�'�"I�
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
SIGN CONTRACTOR 1 + � 0 TELEPHONE 2:��- Sr�s'
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
I hereby certify that the above information is correct and that the construction of the above described sign will be in
accordance with the laws,rules and regulations of the State of Washington and the City of Yelm.
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Applicant's Signature Date
Owner/Contractor/Owner's Agent/Contractor's Agent I Tenant (Please circle one.)
All permits are non-transferable and will expire if work authorized by such permit is not begun
within 180 days of issuance, or if work is suspended or abandoned for a period of 180 days
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105 Yelm Ave W (360)458-3835
Yelm,WA 98597 (360)458-3144 FAX
www.ci.yelm.wa.us