20140262 Permit Pkg 10172014 �o�TH�p,� City of Yelm Permit No.: 20140262
.� ��
� � Community Development Department Issue Date: 10/17/2014
(Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
L
Fax: (360)458-3144
Applicant:
Name: YELM LIQUOR& BEVERAGE Phone: 458-4014
Address: 16602 106TH AVE SE, STE A1
YELM WA 98597
Property Information:
Site Address: 16605 106TH AVE SE STE A1 owner:
Assessor Parcel No.: Subdivision: Lot:
Contractor Information:
Name: YELM LIQUOR& BEVERAGE Phone:
Address:
16602 106TH AVE SE, STE A1
YELM WA 98597
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: GRAND OPENING- MOVED TO NEW LOCATION
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SE YELM LIQUOR&BEVERAGE $ 0.00
TOTAL FEES: $ 0.00
Appl' anYs Affidavit: OFFICIAL USE ONLY
I cert y that I have read and examined the information contained within the application and know the same
to b true and cor . I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints:
Yel 'regul� s inc ding those governing zoning and land subdivision, and in addition,all covenants,
ease ent5 and res ictions o re d. If applying as a contractor, I further certify that I am currenNy Final Inspection:
registered�r�the S ate of h� on.
Signa ure Date � ` Date:
Firm � BY:
�i�c��2
��o� ����` �t�� Of �['�j?2
. � �
� Community Develo�ment �epartment
s��cr�.� �v�.�����o��Y vsE
Y�y� A�'PL�CA3'IDN
W49{i�lICTO N
Special Event Sign Permit(�irnited to �a days,4 times per calendar year)
Temporaty Use {property owner permission letter required)
{see �2EVERSE for regulations}
NAMF OF PROJECT �'�Y(,Lj(1� 0 �'h'11 Y) "m � r�L � c�. nev� t occ�.-1� 1� �
APPLlCANT/BUSlNESS NAME � �Q,Y ��
Mailing Address 1�0�,� `b�o`rn .�kV�, S - Su�t-��2 -1 `��f�� �
�����
City, State and Zip
Telephone 3�0(� - ��-�01� EMAIL �C2 1 ,�.ti1�G��}��-YIE�
City of Yelm Business License Number ��l0 - '��
SITE OWNER ��C,� (��r�S�-sr S
Mailing Address 1�a 2 S �Yl 1�l �
City, State and Zip`
Telephone - - 1 EMA1L
StTE ADflRESS/�OCATION � 1 Y � S .�'��' ��
�1��vr� �.��� �1����`1
S/TE PARCEL 1VUMBER
SLlMM.4RY OF RFQtlEST 1 1 1 � �a- �Y
(��`�� l��.1'1�'I- �-'s1�1 � ��° � Gl-�r YY1f�(�� �"D C�-- Y�1�-1
1r;r�a-�t�,n��r�G� ��.�n��Y1�11.
STARTDATE \��y'l� � END DATE -�v - � -
I affirm that all answers, statements and information abave and submiried with this applicaiion are complete and
accurate to the best of my knowledge. I also a�rm that! am the owner of the subject site or am duly authorized by
tl�e owner to ac#wit� respect to this application. Further, I grant permission from the owner io any and all
employees and representatives of the City of Ye{m and other governmental agencies to enter upon and inspect
said property as reasonably s roces pl' �
Signed Date ��°��J ��
ROUTING: SP�CIAL EVE(�7 Building Section
TEMPORARY US� Planning Sectian Bu�lding Section
I05 Yelm Auenue West (3�0) �1�8-3S3S
Yelm, WA 98597 -°" „Y-, � L� (3f,0)158-3144 FAX
�"'.��1�.I�` ' www.ei.yclm.ua.us
OCT 17 2014 �
� d ' dZO�Z l b�L l��O
i