202 Cullens St NW (2) �� CITY OF YE�M OFFICIALUSEONLY
�"�f THFp�� � 105 Yeim Ave. W. FEE $35.00
��Q �� Yelm, WA 98597 CommyDev.Dept.
� � � (360) 458-8437 OFFICE Bldg Dept �� / �
� (360) 458-4348 FAX Insp.Date
� www.ci.velm.wa.us
Lic.No.
Y'ELM APPLICATION FOR
WASHINGTON �j 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
I� NEW BUSINESS � NAME CHANGE/MAILING ADDRESS CHANGE ONLY
DATE November21, 2013
BUSINESS NAME Sea Mar Community Health Centers
NATURE OF BUSINESS �CC01)Ger�eral Construction Contractor
.?.�'!" �C�, l�N I�'c .
BUSINESS LOCATION ADDRESS � � 8
� " p�l �T •l�. 41�0 ...
MAILING ADDRESS • � /�� �--
ANTICIPATED OPENING DATE
DAYS& HOl1RS OF OPERATION �' � ��� Ig�' ` y ' d� � �
�WNER(S) Corporation _
Birthdate
Address
City State Zip
TELEPHONE z06-763-5277
(Business) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO. CC SEAMACH990P5
(If applicable)
THURSTON CO. HEALTH APPROVAL NO.
STATE OF WASHINGTON MASTER BUSlNESS LICENSE NO. (UBI) 600-537-278
� 11/21/2013
Signature "� , -�" Date
C!�6'`�� ��
Page 1 of 1
V[��s��uigton State Depai�nent of Revenue
St.ate Busuiess Records Database Detail
TR!{ REGISTRATION NO: 600683884 ACCOUNT OPENED: 12/01,/2011
UBI: 60U537278 ACCOUNT CLDSED: OPEN
EMTITY N�kME: SEA MAR COMMUNITY HEALTH CENTER
BUSINE55 NAME:
MAILING A6DRE55: BUSINE55 LOCATION:
2U5B LILLY RD NE STE A 2201 6TH AYE STE 1550
OLYNIPIA�,WA 98506-7401 SEATTLE,WA 98121-1800
ENTITY TYPE: NOt�PROFIT CORP RESELLER PERMIT NO: N/A
PERMIT EFFECTIYE: N/A
MAICS CODE: 923130 PERMIT EXPIRES: N,/A
NAICS DEFINITION: ADMINISTRATION�F HUMAN
RESOURCE PRQ�RAMS�(EXCEPT
EDUCATIQN,PUBLIC HEALTH,
AMD YETERANS'AFFAIRS
PRDGRAMS)
F�R N[lN-��MMERCIAL USE �NLY
12�03/2013 9:53 AM
http://dor.wa.gov/images/BRDImage.aspx?tra=32oe3y6bPRC/kOq 1 Ij dFj e6m8ihs/Bcy&rs... 12/03/2013
O�F TH�p�� Ci�y of �'el�n
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Public Worhs Department
105 Yelm Aven.�e West
Yelm, WA 98597
YELM
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Date: Ip7-��
Prope�ty Address: O�� ����'y!S" f'f r;(�Ct� �,G�� 7d'�7
Business License Applicant: _��A�. ��r ��rnm� l°�t�u!�:�'�t
Dear Applicant:
Section 13.04.220 YMC requires all 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:
�to approval of your business license ,�AC����� ,�sst�-,.� � � a--�- � �
❑ Within days of change of ownership G✓�-�"`' ��-�^- ��s �
❑ Not Applicable ,� �� � ���, ��r.r��- f� G�y--�-�-�f
��io�!�� 4���c,�- .�v/�C -
Contact Kevin Ray, City of Yelm Public Works (360) 458-8410
kevinr(a�ci.�elm.wa.us for defails on device options and inspection
requirements.
Fats, oils, and greases entering the City of Yelm STEP sewer system can adve�sely
affect the operation of the plant and the City requires all appropriate measures to avoid
fats, oils and greases f�om entering the system. Section 13.08.090 Yelm Municipal
Code requires an app�opriately sized grease interceptor to be installed prior to the
STEP tank.
Installation of a G�ease Interceptor is required:
_ --_-_��'-uor--to-a�pr$v�l-vf-y��fbUSiness ficense _.__ --- . ..--- --- _- _.._ .._. _. ___._ . _._.___.___._ __-_ -__.__
- - - -
_ _ _ __ _ _ ___- ----- ----------- ----------
------ ------------
❑ �thin days of change of ownership
❑ Not Applicable
Contact Jim Doty, City of Yelm Public Works (360J 458-8411
Iimd(a�ci.velm.wa.us fordetails.