9144 Burnette Rd SE, Ste B-4 u�, CITY OF YELM OFFICIALUSEOPlLY
�4-Q� �j�p�� 105 Yelrri Ave. W. FEE $35.00
,r Rec By
�{� °�� Yelm, WA 98597 Comm Dev.Dept.
� '�� (360) 458-8437 OFF�CE Bldg Dept. �
(360) 458-4348 FAX Insp.Date � �"`� �`'
�,�.�i.�elt�.��,�as
Lic.No.
YELM APP�ICAT6ON FOR
WASHINGTOI�H B0./SI�ESS LIVEI��E ���-/�
I �
Upon receipt of the license application and $35.00 payment, the City of Yelm will conduct an inspection of
the premises for buiiding 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.
Applec�tAOre os he�eby r�aade for a Busaness Licea�se f�r the C�ty o�Yel�a
� r= Mt�EW�U�ldV�SS � NAME CFIANGE/MAsALlNG ADDfiESS CFiANGE ONLY
DAl"E /' �'-/ �
; ^� .� �bb.0 ,
�US��iE�s NAME ! ,.�1'l� i� L/�>7irJ �{ �� �
N/�T196�E OF �USINESS f i"� �����S� ,
��1SeNESS LOCATION AD�R�SS " �� ^.'..���Y �1Ji � �
M�19LItd(;ADDRESS ����
EMAIL lADDBaESS�:S �i�','��!'� �l �,�(1,� ��"/� t��,��
_ J
ANTICIPA►TED OPEPI&rIG DATE � � � � ��
DA`(S � HOURS OF' OPERATION (//'� �
O'WNEfZ(S)
Adclress Z Z Z_ lr ,,l ��
City State Zip
r��.���orv� ��� � ��` - .�/�'?��
(Business) (Home/Emergency)
t/�I�I�IVI�/�o�9� ��������'o1Y 170.
(If applicable)
THURSTON CO. HEALTH APPROVAL NO.
STATE OF WASHINGTON MASTER BUSINESS LICENSE NO. (UBI)I/I �/ �� � .� �
�" � � ,,�"
�
Signatu��2 . Date��
�..__
Page 1 of 1
���hu�gton ���t.� D�p�trtm�nk +�f R.ev�enue
���te �usine�ss R�c+ords I��t�b�se I�+e��il
TA7{ REGISTRATION NO: 601163582 ACCDUNT QPENED: 07 f Q1,t'�004 12:Oi]:OQ AM
UBI: 601163682 ACCOUNT CL�SED: OPEN
EHTITY NaME: 'WOOD DEfYISE S
BUSINESS NAME: DENISE WOQD LMP
NIAILIMG ADdRE55: BUSIfVE55 LOiCATION:
PO BOX 12�2 ��08 3�'DTH 5
RaY,WA 48580-1222 ROY�WA 98580�-OQ00
ENTITY TYPE: SQLE RROPt�IETOR RESELLER PERMIT MO: M f A
PERMIT EFFECTIVE: N/A
N#ICS CQDE: 812199 PERMIT E}CPIRES: N f'A�
NAICS DEFINITIUhV: OTNER PERSQNAL CARE
SERKICES
FQR NUN-�(�MMER�IAL USE�NLY
ai�os�zais ii:is nr�
http://dor.wa.gov/imagesBRDImage.aspx?tra=kYsQFPJzVyztSd6dcmhObbV CH/vSJGFr&r... 1/8/2015
_
. ' 4,�� TH�p�� City of �'elm
�,4 �'r
a �
Public Worhs Departme.nt
105 Yelm Auenue West
Yelin, WA 98�97
YELM
W4SHINGTON
Date: ����
Property Address: ���� ��fh��tQ� l� . S� � � `7
Business License Applicant: ^��'�L�2 �/lJ a�� �,�t'1�,�
Dear Appiicant:
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 approvai of your business license
❑ �hin days of change of ownership
��Not Applicable � � �—
Contact Kevin Ray, City of Yelm Public Works (360) 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 Ye(m Municipal
Code requires an appropriately sized grease interceptor to be installed prior to the
STEP tank.
Installation of a Grease Interceptor is required:
C �rior to approvai of your business iicense
❑ Within days of change of ownership
❑ Not Applicable
Contact Jim Doty, City of Yelm Public Works (360) 458-8411
limd(a�ci,yelm.wa.us for details.