213 Yelm Ave W (2) CITY OF YELM OFFICIAL USE ONLY
�G-O� T�J�� 105 Yelm Ave. W. FEE $35.00
Ov � CommyDev.De t.
9 Yelm, WA 98597 P
� � (360) 458-8437 OFFICE aidg oept:E l ��' ���-:''�
(360) 458-4348 FAX Insp.Date
www.ci.yelm.wa.us
Lic.No.
APPLICATION FOR
YEL HM TON BUSINESS LICENSE ' 1 �"��
Upon receipt of the license application and $35.00 payment, the City of Yelm wili 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 B SINESS � NAME CHANGE/MAILING ADDRESS CHANGE ONLY
DATE L C_: c�" � d�J �
BusiNESS NannE �e�B��:T"S ���� S�L I ��i� ����� �C�
NATURE OF BUSINESS �� " v.'J-`>�� � C— �
BUSINESS LOCATION ADDRESS ��� �= � N�_/: ����� `�'���1 w -
MAILING ADDRESS I ' 'tC�� �Y2l U �1 �C�d�J S�'� � - `7 �/�'1 . �'-Y ��.5 �� 7
EMAIL ADDRESS A rCt Y'LCl�I 1��I�C K--�S � U1�'] (�� ��l.(-1
ANTICIPATED OPENING DATE �C7'U r� . �-� I LI
DAYS 8� HOURS OF OPERATION �7 " � ��1�1� ��'�4 �vJ'�I��,;���Q
OWNER(S) /�� «�<��I �r� � ��S
Address � d(,� .�`�C'-t (n�1c1 �� . �C ��:.���n \,U/-� _ �,j�
\ / / City State Zip
TELEPHONE � �CU� 1 7�I — 7�U�
(Busine ) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO.
(If applicable)
THURSTON CO. HEALTH APPROVAL NO.
STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI) LS��i�� ` �`�� ��d
Signature /�—� � �� Date �� � �
Page 1 of 1
�'Vashui�tan State Department_ of Revenue
State B�usiness Recards D�t�base L?etail
TAX REGISTRATION NO: MON-REYENUE ACCOUNT OPENED: 1OJ01/2014
UBI: �6Q3443370 ACCQUNT CLOSED: OPEN
ENTITY NAME:
BUSINESS NAh1E:
MAILING ADDRESS: BUSINE55 LOCATIQN:
1Q406 BRIGHTON ST 5E 10406 BRIGHTON 5T SE
YELM,WA 98597-0000 YELM�WA 98597-0000
ENTITY TYPE: LIMITED LIABILITY RESELLER PERMIT NO: N/A
PERMIT EFFECTIYE: N/A
NAICS CODE: 999990 PERMIT EXPIRES: N f A
NAICS DEFIfYITIOM: NjA
FOR NfJN-C�MIMERCIAL USE �NLY
1Oj27j2014 1:46 PM
http://dor.wa.gov/images/BRDImage.aspx?tra=Dh4D63nM7U/9AFA4FhbEZQ==&rsp= 10/27/2014
0� TNF A •
� �.�� Ci ty o f Ye lm
a M
Public Works Department
105 Yelm Auenue West
Yelm, WA 98:i 97
YELM
WASHINGTON
Date: ���4�� � �S�la�-t.�e..r�rii I � ,
�t(,e
Property Address: � � � /�/ w, � �.... ���'f
Business License Applicant: . ��(�
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: ����y `� �� ��
❑ Prior to approval of your business license �(/c�:�, � �l�1J�-.
❑ Within days of change of ownership
❑ Not Applicable
Contact Kevin Ray, City of Yelm Public Works (360J 458-8490
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
i affect the operation of the plant and the City requires all appropriate measures to avoid
fa±s, oi!s �C�� y�°�S�S fi o�m 2ilici i(1� the system. Section i 3.08.090 Yelm i�iunicipa(
Code requires an appropriately sized grease interceptor to be installed prior to the
STEP tank.
Installation of a Grease Interceptor is required:
C Prior to approvai oi your business iicense
❑ Within days of change of ownership
❑ Not Applicable
Contact Jim Doty, City of Yelm Public Works (360) 458-8411
jimd(a�ci.�elm.wa.us for details.