305 B Creek St SE � � CITY OF YELM OFFICIALUSEONLY
�A� T�/�~`'� 6 105 Yeim Ave. W. ReC BY35.00
Q �j� �J Yelm, WA 98597 Comm Dev.Dept.
� � � (360) 458-8437 OFFICE Bldg Dept.��� �
�.� (360) 458-4348 FAX insp.Date
www.ci.yelm.wa.us
`� Lic.No.
�
YELM APPLICATION FOR
WASHINGTON 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 will process the apptication and mail license to applicant at
address listed below.
Application is hereby made for a Business License for the City of Yelm
C�I NEW BUSINESS C� NAME CHANGE/MAILING ADDRESS CHANGE ONLY
DATE I � � l� I � I �
BUSINESS NAME 1`����� ��� � ���'�� I��
NATURE OF BUSINESS ������ ��0 �� �G � �����i�G�C� �
BUSINESS LOCATION ADDRESS �L�� � C�X� � �JT �� �� �� � ������� (�
MAILING ADDRESS �� V����
ANTICIPATED OPENING DATE I 2 � U I -� �
DAYS 8�HOURS OF OPERATION_ �� ' � "1 U( �'�''
OWNER(S) F�.6��'� VV"I Q G 1� � ���� �i�� �G� S�'L�'l°',
Birthdate �� r����
Address � �o�"� �� ����� ��1/x� �� y� ��,'� (,U f�" �� ����
City State Zip
TELEPHONE �l-i'�}• `"�`��° 'rF�U�' �J'(,."(j 7G � . (�'�j- 3
(Business) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO. `
(If applicable)
THURSTON CO. HEALTH APPROVAL NO. "'
STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI) U�� I�7j ���
signature � ���� ' '� `L"�JLIo�� oate �L - �._ ���
Page 1 of 1
��'�5hut�ton State DegRt�nent of R�venue
Stat� Business Recorcis Database Detail
TA}{ REGISTRATION NO: 6Q3173163 ACCOUNT OPENED: O1/O1/2012
UBI: 6d3173163 ACCOUNT CL05ED: �PEN
ENTITY NAhiE: XTREME DESIGNS NW LLC
BUSINE55 NAME: XTREMEDESIGNS
MAILING ADDRE55: BU5INE55 LOCATION:
18510 138TH AVE SE 18510 138TH AYE SE
YELM,WA 98597-9342 YELM,WA 98597-9392
ENTITY TYPE: LIMITED LIABILITY RESELLER PERMIT NO: A25 3997 14
PERMIT EFFECTIYE: 02/16/2012
IYAICS CODE: 323113 PERMIT E%PIRES: 02/15/2Q14
NAICS dEFINITION: CDMMERCIAL SCREEN
PRINTING(PT�
F(�R N�N-C�IMMERGIAL USE (�NLY
12J05J2013 4:06 PM
http://dor.wa.gov/images/BRDImage.aspx?tra=Tj91 qlikTyVZFigN4pJ42gRvRzNnSHhB... 12/OS/2013
�°f THFp�9� City o f Yelm
a M
Public Worhs Department
105 Yelm Auenue West
Yelnc, WA 98597
YELM
WASHINGTON
Date: --��J ��
Property Address: �Q � C.•���� ��' , -°- �,� ��.,�� �
e
Business License Applicant: �/"d " ''1� � � � � ,�
Dear Applicant:
Section 13.04.220 YMC requires all commercial buiidings and irrigation systems to have
a Reduced Pressure Backflow Assembly (RPBA) device installed on the water services.
Installation of a Reduced Pressure Backflow Assembly is required:
❑ Prior to approval of your business license
❑ Within days of c�ange of ownership
� Not Applicable '
___ ��----
Contact Kevin Ray, City of Yelm Public Works (360) 458-8490
kevinr(a7ci.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 piant and the City requires all appropriate measures to avoid
fats, oils and greases from entering the system. Section 13.08.090 Yelm Municipal
Code requires an appropriately sized grease interceptor to be installed prior to the
STEP tank.
Installation of a Grease Interceptor is required:
- C Prior to approvai oT your business license - - - --- -
❑ Within days of change of ownership
❑ Not Applicable
Confact Jim Doty, City of Yelm Public Works (360) 458-8411
jimd(a�ci.Velm.wa.us for details.