20140206 Permit Pkt 07252014 �p� TH�P�� City of Yelm Permit ►vo.: 20140206
7
� 4� Community Development Department Issue Date: 0/00/0000
d M (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
ELM
"".`"'"`_°" Fax: (360)458-3144
Applicant:
Name: MT RAINIER PROPERTIES Phone: 302-332-6389
Address: 9144 BURNETT ROAD SE
YELM WA 98597
Property Information:
Site,4ddress: 9144 BURNETT RD SE Owner: TYPE CURRENT OWNER
NAME
Assessor Parcel No.: 21713340601 Subdivision: N/A Lot:
Contractor Information:
Name: DREAMTIME VISUAL COMM., INC Phone:
Address: DAVID KEENAN
PO BOX 2324
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: SIGN
Description of Work:
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SIGN DREAMTIME VISUAL COMM.,INC $ 20.00
TOTAL FEES: $ 20.00
Applicant's 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 regulations including those governing zoning and land subdivision,and in addition,all covenants,
easements and restrictions of record. If applying as a contractor,I further certify that I am currently Final Inspection:
registered in the State of Washington.
Date:
Si nature Date -D�
Firm !/"f' By
Cit� af Y�lm
(36 ) 458-8402
REC#: 00167226 7/25,�2014 2:14 PM
UPER: CO TERM: 001
REF#: 15748
TRAN: 33.d000 BUILDING PERMITS
201�020b 20.00CR
MT RATNIER PROPERTIES
9144 BURNETT RD SE
SIGN 20.00CR
TENDEREQ: Z0.00 CHECK
APPLIED: 20.00-
CHANGE: 0.00
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CITY OF YELM I uv
SIGN PERMIT APPLICATION FORM
�
ProjectAddress:�-'��� ���� '✓��� ✓�� Par el#:
/
�
Zoning; Current Use:� �� �r�o��posed Use:
Type/Number of Sign(s) (m�l, monument, lighted, �):������ �����"'�'u j,C��
Value of each Sign: , , �ii�
, �,b d
Dimensions of Sign(s): Lrg ` �_ ��
Building Gross Floor Area(sq. ft):
Building Height:
Existing Signage(if any) and dimensions: �'� T�'`-'�
APPLICANT �`ti '� � - / =-� --
Last Nayge����,��`/�� First Na�me� � /y�
ADDRESS t° �U �v EMAIL /V�l�✓�LC.�i G�/�JC�J'G�'�. � l
CITY " STATE ' ZI � TELEPHONE � L�
BUILDING OWNER
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
BUILDING TENANT
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
SIGN CONTRACTO / � � TELEPHONE
ADDRESS �>> � � EMAIL iti �l� — ��� "�`"�
CITY ' STATE ZI FAX
CO RA TOR'S LICENSE# EXP DATE CITY LICENSE#
I hereby certify that the above information is correct and that the construction of the above described sign will be in
accordance with the laws,rules and regulations of the State of Washington and the City of Yelm.
� /,�°� , .
C
Applicant's Signature Da e
Owner/Contractor/Owner's Agent/Contractor's Agent/Tenant (Please circle one.)
All permits are non-transferable and will expire if work authorized by such permit is not begun
within 180 days of issuance,or if work is suspended or abandoned for a period of 180 days
: - �:.,Q ' ��.�...�' i
r
� JUL 1 6 2014
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�___._ _.____.__.,___
105 Yelm Ave W (360)458-3835 �
Yelm, WA 98597 (360)458-3144 FAX
www.ci.yelm.wa.us
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