10501 Creek St, Ste 7 �� �� C ITY O F YE�M OFFICIAL USE ONLY
� ►�� ���� 105 Yel�rn Ave. 1�1. FEE $35.00
Rec By ,f �
��Q� g� �e�i'Tl, WA 98597 Comm Dev.Dept. � �'
� � (360) 458-843% OFFICE BldgDept.
(360) 458-434�8 FAX �nsp.�ate
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Lic.No.
'YELM AP�LICA`TIOdV FOR
WASHINGTOP/ 8�,���,ES� L'���,�E � 11�'�
Upon receipt of the license application and $35.00 payment, 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.
Ap�licatoo� is here�y r��de for a �usoness Licer�se f�r th� Coty of Yeia�
t� NEW�USBN� S � NAME CFIANGE/M�41LIdVG ADDRESS CFiANGE ONL`�
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DAT'� �. �o,'�.��f S
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t�J��'URE OF �USINESS �/l r�(,t� �e.�,.t,.p�t� � ����sS �'� (t+�PS
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ANTICIPATED OPENIrIG DATE /^�_ %�� , ��? /s �
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City State Zip
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(Business) (Home/Emergency)
COi�iTRi0.CTOlZ'S REC;ISTRATION iVO.
(If applicable)
THURSTON CO. HEALTH APPROVAL (VO.
STATE OF WASHINGTON MASTER BUSINESS UCENSE NO. (UBI) �O � 3�-� � (,�
Signature ��%�`����..>?2� � �.�� Date �.e�,` C� �. ��',m�r-
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Page 1 of 1
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TAX REGISTRATIDM NO: 603349417 ACCOUNT OPEh1ED: 12 f 01{'�013 12:O�:OD�M
UBI: 6433d9417 ACCUUMT CLOSED: OPEN
ENTITY NAME: PR!#Y KATIE
BUSINESS N�tME: QU1#LIT'�C05TUME]EWELRY
MAILING ADDRE�S: BUSINE55 LUCATION:
202 EDWARDS ST MW 273 SU55EX AYE UMIT C-D
YELM,WA 98597-7510 TEh1IM0,WA 98589-9360
ENTITY TYPE: SQLE PROPRIETOR RESELLER PERMIT MO: A29 4500 15
PERMIT EFFECTIYE: 12f0112013
N�►ICS COUE: 448150 PEFtMIT EXPIRES: 11 f 30 j'2015
NAICS DEFINITIDN: CLOTHING AttE550RIE5
�TORE5�[PT)
F�}R N�N-�DMMERCIt�L USE �NLY
U�2 f O6/2015 2:5�PM
http://dor.wa.gov/imagesBRDImage.aspx?tra=EAcytV VKS W�ZuH66IyNpvW 1 nD47eJD... 2/6/2015
` �.o� THE p'Q� �i ty o f �e l m
,�4 9r
� �
� �
Public YVorks Department
105 Yelm Auenue West
Yelrr�, WA 98597
YELN�
WASHINGTON
Date:
� �—/s'
Property Address: �Q,� 1 �/��� �, �-� 7
Business License Appiicant: .
Dear Applicant:
Section 13.04.220 YMC requires all commercial buiidings and irrigation systems to have
a Reduced Pressure Backflow Assembly (RPBA) device installed on the water services.
Jnstaliation of a Reduced Pressure Backf(ow Assembly is required:
❑ Prioc to approval of y�ur business license
❑ ,�Vithin d �s of �°hange of ownership
� Not Appiicable � � :'
�r `� �
' Confact Kevin R�y, City�'�of Yelm Public Works (360) 458-8410
kevinr(c�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 a�i appropriate measures to avoid
f?tc nilc anul yro�c°S f�O�i i ciiici ii iy ii ie sysie���. Seciion i 3.vu.vyu Yeim iviunicipal
Code requires an appropriately sized grease interceptor to be installed prior to the
STEP tank.
Installation of a Grease Interceptor is required:
� ��iar to approvai oT your business (icense
❑ Within days of change of ownership
❑ Not Applicab(e
Contact Jim Doty, City of Yelm Public Works (360) 458-8411
jimd(�a,ci.yelrrr.wa.us for details.
� CITY QF YELM
;
; Clerk—Treasurer's Office
! 2015 BUSINESS LICENSE
,I Not Valid Until Fee is Paid
QUALITY COSTUME JEWELRY '
���, �. (
�;f IS HEREBY AUTHORIZED TO OPERATE
���� " QUALITY COSTUME JEWELRY
�
202 EDWARDS ST NW I
i
� YELM WA 98597
^, �j � AT: 10501 CREEK ST SE � M �h�%.�<F
ii This license must be posted in a conspicuous place at the business location
, License Number: 11116
Payment Record —keep this portion for your records
CITY OF YELM
OFFICE OF CLERK TREASURER
105 YELM AVENUE WEST• YELM, WA 98597
LICENSE NUMBER 11116
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11116 RETAIL
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� $ 35.001
CITY OF YELM
OFFICE OF CLERK TREASURER
105 YELM AVENUE WEST • YELM, WA 98597
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11116 RETAIL QUALITY COSTUME JEWELRY
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