201 Tahoma Blvd, Ste 207 REC��� �i' ,
D�C 0 g 2014
��:
CITY OF YELM OFFICIAL USE ONLY
���� TNF�,�� 105 Yelm Ave. W. FEE $35.00
Rec By
q '�r Yelm, WA 98597 Comm Dev.Dept.
� � (360) 458-8437 OFFICE B,dg oept.;a;�-� i��� ;� �i�,� !
(360) 458-4348 FAX ` `
Insp.Date
www.ci.yelm.wa.us
Lic.No.
YELM APPLICATION FOR
� WASHINGTON BUSINESS LICENSE � l D �'�o
\
Upon receipt of the license application and 35.00 ayment, 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.
�pplication is hereby made or a Business License for the City of Yelm
� NEW BUSINESS NAME CHANGE/MAILING ADDRESS CHANGE ONLY
DATE i���;I a G1�
BUSINESS NAME f'I T� 1"�`IS�CG� I ! � ��`'I
NATURE OF BUSINESS O�l.k�'��[l� �PhyS'��I ��P�I
BUSINESS LOCATION ADDRESS �C,J I TGl.�1 C?rr101 ��UC�-�StC ���� �elm��;w- G S� 7
MAILING ADDRESS �a� ���'Y�tY1G��f1 �`V� . �G 1��Q ��p 1L� �L— �-��1 C,�
EMAIL ADDRESS Iv � �
ANTICIPATED OPENING DATE NI.s�SYl�� ��I�
DAYS 8� HOURS OF OPERATION �"" �" �C�M -- �rr: Sct�- �Sun �' I��d
owNER�s� ��1G`n ��tt� y CCO
Address ��J �,t�Yl tYlGr'rCYI ►J`�� - , �JGI�`n,o Y�� TL- �L'�/G
\ , City State Zip
TELEPHONE C�� D J� 9C1� ^c�'C�3�'� C(I�,�O) a d4"QIL/3
(Business) (Home/Emergency)
CONTRACTOR'S REGISTRATION NO. �1�I �rC
(If ap,,f�lic�le)
' THURSTON CO. HEALTH APPROVAL NO. `�► ( /��
STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI) ��(�� `�'!G(C����
Signature �/1.��b Date � � ��� �Q��
Page 1 of 1
�`��hi�t�tc�i� �t�t.�e I���a�rtrrt�nt +�f R.�v��enu+e
����e �u�ine�s� Ft��+�rds I���a�as� I�etail
TAX REGISTRATIOfV M0: 601920277 ACCOUNT QPENED: 04fA1%200112:OQ:OQAM
UBI: 601920277 ACCOUNT CL05ED: OPEN
ENTITY NAME: APPLE PHVSICAL THERfkPY LLC
BUSINE55 NANIE: kTI PHYSICAL THERAPY
MAILING AddRE55: BUSINE55 LOCATION:
290�#4TH AYE ME STE 300 22739 SE 29TH ST
PUYALLUP,WA�9�8372-7053 SAMMAMISH,WA 980?5-0000
ENTITY TYPE: LIMITED LIABILITY RESELLER PERNIIT NO: a17 8221 17
PERMIT EFFECTIYE: O1}'01�2014
NAICS CODE: 621�40 PERMIT E%PIRES: 12,f�i f2D17'
NAICS DEFINITION: OFFItES OF PHYSICAL'
OCCUPATIOMAL AMD SPEECH
THERAPISTS,ANU
AUDIDLaGISTS
F�R N�M-��MMER�IAL USE �NLY
iz/ia/2oia s:2s nM
http://dor.wa.gov/images/BRDImage.aspx?tra=CPV9NE48mfbPc55U0173ysrYIqpj+ter... 12/10/2014
q�� THF p�9� Ci ty o f Ye l fn
a M
Publi.c Wor�ks De�artment
10.5 Yel�n Auenue 4Vest
Yelrn, WA ,98i97
YELM
WASHINGTON
Date: ����—'��
Property Address: l � �� �,�(�• � �b� � �� ` �`� I�
Business License Applicant: �r�,0 «�
Dear Applicant: 'T� ��'yS� ����"
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 license
Within days of change of ownership
o Applicable �"�
,
Contact Kevin y, City of Yelm Public Works (360J 458-8410
kevinr(a�ci.�elm.wa.us for details on device op�ions 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:
C Prior to approvai ofi your business license
❑ Within days of change of ownership
❑ Not Applicable
Contact Jim Doty, City of Yelm Public Works (360) 458-8419
jimd(�ci.►relm.wa,us for details.