20140149 Permit Pkg 04102014 ��pE ZH�p� City of Yelm Permit►vo.: 20140149
� �� Community Development Department Issue Date: 4I10/2014
(Work must be completed within 180 days)
Building Division
Phone:(360)458-8407
LM
"""„'""°" Fax:(360)458-3144
Applicant:
Name: SOUTH PUGET SOUND HABITAT FOR Phone:
Address: 415 OLYMPIA AVE NE
OLYMPIA WA 98501
Property Information:
Site Address: 412 YELM AVE E owner:
Assessor Parcel No.: 22719340500 Subdivision: Lot:
Contractor Information:
Name: SOUTH PUGET SOUND HABITAT FOR Phone:
Address: CALEB
415 OLYMPIA AVE NE
OLYMPIA WA 98501
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: THE MEN OF MCKENNA CHURCH WILL BE PROVIDING BIKE REPAIR. WILL PUT OUT A
SANDWICH BOARD. MAY 3 THRU MAY 17,2014
Sq. Ft. per floor: First Heat Type(Electric,Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SE SOUTH PUGET SOUND HABITAT FOR $ 0.00
TOTAL FEES: $ 0.00
ApplicanYs Affidavit: OFFICIAL USE ONLY
I certify that I have read and examined the information contained within the application and know the same
to be true and correct.I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints:
Yelm re lations including those governing zoning and land subdivision,and in addition,all covenants,
easeme ts res ictions of record.If applying as a contractor,I further certify that I am currently Final Inspection:
register d i the St e of hington
Date:
si natu e Date (D �
` r. By:
Firm .
�c�i u� ��Eq
�'�,Q� T"'�A�,,, City o f Yelm
� ,, �
Community Deuelopment Department
SPECIAL EVENT/ TEMPORARY USE
APPLI CATION
EL
WASHfMZiTOM
Special Event Sign Permit (�imited to �a days,4 times per calendar year)
TempOraty Use (property owner permission letter required)
(see REVERSE for regulations)
NAME OF PROJECT ��� �j� �e�l n � � ���� ��/ �
APPLICANT/BUSINESS NAME
Mailing Address �h� 3 S �� _ S',
� �r.�'�
City, State and Zip �' S.
Telephone � y EMAIL ` �° r?G B�'
City of Yelm Business License Number
SITE OWNER 5�c�
Mailing Address � � a J�e- -'
City, State and Zip �e v�. SQ7
Telephone � � 4S - � �x3 EMAIL t6���t . r
SITE ADDRESS/LOCATION Z a J � 2�� i.J� 5��
SITE PARCEL NUMBER
SUMMARY OF REQUEST � � - r �
�c-� �t�� b� u � c`
r� � �vo r�.�
START DATE 5 END DATE S
I affirm that all answers,statements and information above and submitted with this application are complete and
accurate to the best of my knowledge. I also affirm that I am the owner of the subject site or am duly authorized by
the owner to act with respect to this application. Further, I grant permission from the owner to any and all
employees and r re ntatives of the City of Im and other governmental agencies to enter upon and inspect
said property s r a n bly e ary t o this application.
Signed Date
� ROUTING SPECIAL EVENT Building Section
TEMPORARY USE Planning Section Building Section
105 Yelm Auenue West (360)458-3835
Yelm,WA 98597 (360)458-3144 FAX
www.ci.yelm.wa.us
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