215 Killion Rd NW CITY OF YELM ������������ µ
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« ��l�ii��,� (?FFIC4AL USE ONLY
�t�"� ����� 105 Ye{m Ave. W. FEE $35.00
Rec By
� ��'' Yelm, WA 98597 Comm Dev.Dept.
�* � (360) 458-8437 OFFICE e�ds oePt. �
�` ��,�� � (360) 458-4348 FAX Insp.Date
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Lic.No.
APPLICATION FOR
���'� BUSINESS LICENSE � c � � L�
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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
❑ NEW BUSINESS � � NAME CHANGE/MAILING ADDRESS CHANGE ONLY
DATE 6-19-2014
BUSINESS NAME Prestige Senior Living Rosemont
NATURE OF BUSINESS Assisted Living facility
BUSINESS LOCATION ADDRESS 215 Killion Road NW,Yelm WA 98597
MAILING ADDRESS same as above
EMAIL ADDRESS C�:,�K����€ ° �� �1''�' `"� � '� �' ° ��-�`���
ANTICIPATED OPENING DATE
DAYS& HOURS OF OPERATION 24/7 Seven days a week
OWNER(S) CHP Yelm-Rosemont WA Owner,LLC
Address 450 S.Qrange Ave Orlando Florida 32801
City State 2ip
TELEPHONE 360-458-1800 � � _ C.� � C� {j;�,,
(Business) (Home/Emergency)
CONTRAC70R'S REGISTRATION NO.
(If applicable)
THURS70N CO. HEALTH APPROVAL NO.
STATE OF WASHIN�T�N MASTER BUSINESS LICENSE NO. (UBI) 603 334 744
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' Signature �'�� � �� Date �une 18,2014
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Page 1 of 1
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��.�t� �usine�s�� F��c+�rr�s I)����ase T�et�il
TASC REGISTRATIOfM NO: NON-REYENUE ACCOUNT UPE(VED: 0'��18/�013
UBI: 6d3334744 ACCOUNT CLOSED: OPEN
ENTITY NAME:
BUSINESS NAME:
MAILING ADDRE55: BUSIME55 LOCATION:
450 S ORANGE AVE 450 5 ORANGE AYE
ORLANDQ,FL32801-0000 DRLANDO,FL328Q1-OOQO
ENTITY TYPE: LIMITED LIA�BILITY RESELLER PERMIT NO: N,fA
PERMIT EFFECTIYE: N f A
NAICS CODE: 999990 PERMIT EXPIIxES: N f A
NAICS DEFINITION: N/A
FC.�R NDN-G�MMER�IAL USE �NLY
07f 15/2014 4:27 PM
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P�cblic Worhs Department
105 Yelm Aven ue West
Yelni, WA 98�97
YELM
WASNINGTON
Date: ���5��
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Property Address: �� . (Qy(
Business License Applicant: � � �rj-�p��-�-� �� ��
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:
❑ Prior to approval of your business I� ense
❑ Within days of cha�of o ner hip
�Not Applicable f
f / ` ^
./ " \�/
Contact Kevin Ray, City f Yelm Public Works (360J 458-8410
kevinr(a�ci.yelm.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 requires an appropriately sized grease interceptor to be installed prior to the
STEP tank.
Installation of a Grease Interceptor is required:
_ � _P_�ior to approval oi your business license -
❑ Within days of change of ownership
❑ Not Applicable
Contact Jim Doty, City of Yelm Public Works (360) 458-8411
limd(c�ci.yelm.wa.us for details,