201 Tahoma Blvd � � C ITY O F Y E L M OFFICIAL USE ONLY
�'�'�� THF�,� 105 Yelm Ave. W. FEE $35.00
Rec By ,
�4 'yr ��q Yelm, WA 98597 Comm Dev.Dept.s,-:*�-«'�'�'3�'g��
4 � � (360) 458-8437 OFFICE BldgDept�t �"� ��
(360) 458-4348 FAX Insp.Date
�'��, www.ci.yelm.wa.us
� Lic.No.
Y E LM �`' 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 below.
Application is hereby made for a Business License for the City of Yelm
L7 NEW BUSINESS � NAME CHANGE/MAILING ADDRESS CHANGE ONLY
DATE
BlJSINESS NAME
NATURE OF BUSINESS C
' „
BUSINESS LOCATION ADDRESS �%� �
�� ��� � �
MAILING ADDRESS � �
ANTICIPATED OPENING DATE � M � ` i � ✓
DAYS 8� HOURS OF OPERATION �� ��� � Y / �=, �� D
� .
OWNER(S)
Birthdate �� � � ���/���
Address � �' ��'
TELEPHONE�� `�J7"� ��✓ City-J� _��t� � -I �I_�?�p __
L_
(Business) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO.
(If applicable) �� i o �r �O�
THURSTON CO. HEALTH APPROVAL NO. I �.l�
.� i
STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBf) � dC�_ ) ��� �1
Signature �a ^ � Date�( ��Q��/ , ���
Page 1 of 1
�'4'�shin�ton State I�ep�i�tnent vf Reverni�
State �usutess I�ecord� l�atabase� Det�il
TAX REGISTRATION MO: 603323351 ACCOUNT OPENED: 08fU1/2013
UBI: 603323351 ACCOUNT CLOSED: OPEhI
ENTITY NAME: CELLETTI MARTIN D&AMY L
BUSINE55 NAME: M&A COFFEE COMPANY
MAILIMG ADDRE�5: BUSIME55 LOCATION:
201 TAHOMA BLVD 201 TAHOMA BLYd
YELM,WA 9$597-7735 YELM,WA 98597-7735
ENTITY TYPE: SOLE PROPRIETOR RESELLER PERMIT MO: N/A
PERMIT EFFECTIYE: N/A
NAICS CODE: 722515 PERMIT EXPIRES: fVJA
MAICS DEFINITION: SNA�CK AND NONALCOHOLIC
BEVERAGE BARS
F�R N�N-Ct�MMERCIAL USE DNLY
10�03 f 2013 4:22 PM
http://dor.wa.gov/images/BRDImage.aspx?tra=Vm WMqhYNx9bvdMiC 8pZqsNy8nFqr7... 10/03/2013
q�f TNE p'�9�` C i ty o f Ye l jn
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Public YVor�l�s De��
105 Yelm Auen.t�e r� ��
Yelnz, WA 985 ���•'�,-'r-C._l�'�.----
YELM
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Date: ( � ' �'� �_ �
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Property Address: �
� i � Ir�.�o�� ��� �c� -
Business License Applicant: _ � f t `''���" ���Tcx �, � �d/1���'l � `�'Yl
. �
Dear Applicant: ���C��'I'
Section 13.04.220 YMC requires ali commercial buildings 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 o c ge of ownership
�" Not Applicabl
_.---__ .
Contact Kevin R , ify of Yelm Public Works (360) 458-8410
kevinr(a�ci.yelm.wa.us for defails 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 fViunicipai
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 or your business license ��
(� Within �d days of change of ownershi ---
❑ Not Appiicable
Contact Jim Doty, City of Yelm Public Works (360) 458-8411
jimd(c�ci.yelm.wa,us for details.