202 Cullens St NW CITY OF YELM OFFICIALUSEONLY
�Of THFA�� � 105 Yeim Ave. W. FEE $35.00
Rec By
Q �� Yelm, WA 98597 Comm Dev.Dept.
a � � (�60) 458-8437 OFFICE Bldg Dept �� �/ �
� (360) 458-4348 FAX Insp.Date
� www.ci.velm.wa.us
Lic.No.
YELM APPLICATION FOR
WASHINGTON �� BUSINESS LICENSE
Upon receipt of the license application and $35.00 payment,the City of Yelm will conduct an inspection of
the premises for building and fire code conformance. Upon approval from the Yelm Building Department
of said premises, the City Clerk's Office will process the application and mail license to applicant at
address listed beiow.
Application is hereby made for a Business License for the City of Yelm
I�I NEW BUSINESS � NAME CHANGE/MAILING ADDRESS CHANGE ONLY
DATE November 21, 2013
BUSINESS NAME Sea Mar Community Health Centers
NATURE OF BUSINESS �CC01)Ger�eral Construction Contractor
.7.d►` �C-H. �N �''�' �
BUSINESS LOCATION ADDRESS � • �
� ~ � �T ��.
MAILING ADDRESS • � 9$C� �--
ANTICIPATED OPENING DATE
DAYS &HOURS OF OPERATION �' � ��� Ig� � � ' �� � �
�WNER(S) Corporation
Birthdate
Address
City State Zip
TELEPHONE 206-763-5277
(Business) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO. CC SEAMACH990P5
(If applicable)
THURSTON CO. HEALTH APPROVAL NO.
STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI) 600-537-278
a 11/21/2013
Signature � f -�" Date
C!�6'`i� �"� \
Page 1 of 1
�'V'�5�ungtQn St�te Depai�t.ment of Revenue
St�te BLISIRE!SS R�CUI�cIs Datal�ase D�tail
TAX REGISTRATION NO: 600683884 ACCOUNT OPENED: 12/O1/2U11
UBI: 600537278 ACCOUNT CLUSED: OPEN
ENTITY NAME: 5EA MAR CDMMUNITY HEALTH CENTER
BUSINE55 NAME:
MAILING ADDRE55: BUSINE55 LOCATION:
205B LILLY RD NE STE A 2201 6TH AYE STE 1550
OLYMPIA,Y!A 98506-7401 SEATTLE,WA 98121-1800
EMTITY TYPE: NON PROFIT CORP RESELLER PERMIT NO: N jA
PERMIT EFFECTIYE: N/A
NAICS CODE: 923130 PERMIT EXPIRES: N/A
NAICS DEFINITIOM: ADMINISTRATION OF HUMAfV
RESOURCE PROGRAMS{EXCEPT
EDUCATION,PUBLIC HEALTH,
AND YETERANS'AFFAIRS
PROGRAMS)
Ft]R NfJM-C�MMER�IAL USE �]NLY
12J03 f 2013 9:53 AM
http://dor.wa.gov/imagesBRDImage.aspx?tra=32oe3y6bPRC/kOq 1 Ij dFj e6m8ihs/Bcy&rs... 12/03/2013
q�f TH��,�',�� City o f Yelm
a M
Public Worhs Departm.ent
105 Yelm Auen,ue West
Yelnz, WA 98597
YELM
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Date: �p�-�'J�
Property Address: �� ���C'y�� J'� ;,(>�� ��� �C�'��7
Business License Applicant: ��, � �����,�� �����j
,-�.
Dear Applicant:
Section 13.04.220 YMC requires all commercial buildings and irriga �����
a Reduced Pressure Backflow Assembly (RPBA) device installed or �.--�--�-�
��� ��
Instailation of a Reduced Pressure Backflow Assembly is required:
`�-P�r�to approvai of your business license ;�A�k -��o� � �� ��Y;� f � �
❑ Within days of change of ownership G�`�" �-�-�" �`°��' �
❑ Not Applicable ,b� �� � ���, ���-�� f� ���'�f
Confact Kevin Ray, Cify of Yelm Public Works (360) 458-8490
kevinr(a�ci,�elm.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 Yelm Municipal
Code requi�es an app�opriately sized grease interceptor to be installed prior to the
STEP tank.
Installation of a Grease Interceptor is required:
-- --�l��-ior-taa�p-reval-of y��f business license _ ___--. _ _____ _ _. __ __
❑ Within days of change of ownership
❑ Not Applicable
Contact Jim Doty, City of Yelm Public Works (360) 458-8411
jimd(a�ci.Velm.wa.us for details.