210 103rd Ave SE CITY OF YELM OFFICIAL USE ONLY
�O� T�A�� 105 Yelm Ave. W. FEE $35.00
Rec By
`Q 9,� Yelm, WA 98597 Comm Dev.Dept.
� � (360) 458-8437 OFFICE Bldg Dept. S /
(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 application and mail license to applicant at
address listed below.
pplication is hereby made for a Business License for the City of Yelm
NEW BUSIN SS � NAME CHANGE/MAILING ADDRESS CHANGE ONLY
DATE � .�'�!�/�
BUSINESS NAME � � �� '� �� �� 1\ % �� �Y� � ��
NATURE OF BUSINESS � ,l, �L-�\1
BUSINESS LOCATION ADDRESS �� 1 C ��J�� �� " �v'G,
MAILING ADDRESS �Li'� ������ ���v �'�L1� ��� ���C"�C��
ANTICIPATED OPENING DATE � Z- +��''� Zt-��
� � �� �,-.
DAYS 8� HOURS OF OPERATION �' � %� � ' � ' �`��� ' �
__----
� - ��t,� � ' �, � ���- `-'�
OWNER(S) ��U� VC�' ��1� �`� �'vl�� �
Birthdate �-��- ��1�� � ��-1 � --\�'�"��`�
Address�-�`� �'���Q'n \ 1�i �� ����1 �'�� � ���� "I
� . , �- City State Zip
TELEPHONE �� �� ����`'�� �c l,'.__��SS- �5�r' ��c?
(Business) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO.
(If applicable)
THURSTON CO. HEALTH APPROVAL NO.
STATE OF WASHINGTON MAST R BUSINESS LICENSE NO. (UBI) .OV��� �Y ��
� / ;� � � ��
Signature�.'��'� +�JZ"�'� ' ' � '� �r Date � ��� � � +
Page 1 of 1
�ashingtan St�te De�asti�tmen� +vf R.��enue
S��t� Bu�ines� Recar�ds D�t�bas�e D�etail
TIkX REGISTRATION MO: 603364437 ACCOUNT OPENED: 03f01�'�Q1�i 12:0O:OOAM
UBI: 603�64437 ACCOUMT CLOSED: OPEN
ENTITY NAME: T 8�D WOQD LLC
BUSINE55 MAME: MR DOUGS FAMILY RESTURANT
MAILING ADDRE55: BUSINE55 LOCATION:
21 U 103RD AYE SE 210 103RD AYE 5E
YELM,W A 98597-9995 YELM,Wa 9854F-9998
EMTITY TYRE: LINIITED LIaBILITY RESELLER PERMIT M0: N,�A
PEFkMIT EFFECTIYE: N,�f1
NAICS CODE: ?22511 PERMIT EXPIRES: N�!#
NAItS DEFINITIUN: FULL-SERYICE RES7AUR�#NTS
F�R N�N-�C�IMMERCIAL U�E �NLY
�2j0�/2Uld�:12 PM
http://dor.wa.gov/images/BRDImage.aspx?tra=nNUY1B7/V 3tv/51/mzOclKSgHqcSLVFz... 02/04/2014
��f TH�f,'Q.y� Ci ty o f �'e l m
a M
Public Works Department
105 Yelm Auenr�e West
Yelm, WA 98597
YELM
wnsr��r�cro�v
Date: rr �
Property Address: °'"
_ �� C� 3 �-v�e �S�
.� � � .____ �r►-
Business License Applicant: �.�, � � r- .
J�� s
Dear Applicant: l�e S
Section 13.04.220 YMC requires all commerciai buildings and irrigation systems to have
a Reduced Pressure Backflow Assembly (RPBA) device installed on the water services.
Installation of a Reduced Pressure Backflow Assembiy is required:
❑ rior to app�val of your business license
Within days of change of ownership (�
❑ Not Appticable �E�`' `'�� t-��'`bs"�,`' b'�`l`"��"
�s5'rt►-v h�C. (�i �q�✓�u c� --
c��, t'(ti.._ �etFl.(,�--
Contact Kevirr Ray, +Cify of Yelm Public Works (360J 458-8410 ��� �-Ys,t.�N„_,_
kevinr(a�ci.yelm.wa.us for details on device opfions ar►d inspecfion
requirements.
Fats, oils, and greases entering the City of Yelm STEP sewer system can adversely
affect the operation of the p�ant 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.
Instaflation of a Grease Interceptor is required:
- ----___ Ci_ P_rior#o approval oT your business-license-- - - � - - - - - - - - --__ _ -----.---_______------------_
❑ Within days of change of owne�ship
❑ Not Applicable
Confact Jim Doty, Cify of Yelm Public Works (360) 458-8411
limd(a�ci.yelm.wa,us for�details.