20150115 Permit Pkg 02122015Applicant:
City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20150115
Issue Date: 0 /00 /0000
(Work must be completed within 180 days)
Name: JAYNE CAMERON Phone
Address: PO BOX 2040
YELM WA 98597
Property Information:
702 - 845 -5925
Site Address: 102 YELM AVE E Owner: STEVE CRAIG
Assessor Parcel No.: 64400600900 Subdivision:
Contractor Information:
Name: JAYNE CAMERON Phone:
Address:
PO BOX 2040
YELM WA 98597
Contractor License No.: Expires: 0 /00 /0000
Project Information:
Project: SIGN
Description of Work: WALL MURAL AND MARQUE SIGN
Sq. Ft. per floor: t Heat Type (Electric, Gas, Other):
Firs
Second
Third
Garage
Basement
Lot:
Fees:
Item Contractor Fees
SIGN JAYNE CAMERON $ 40.00
TOTAL FEES: $ 40.00
Applicant's Affidavit:
I certify that I have read and examined the information contained within the application and know the same
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regulations including those governing zoning and land subdivision, and in addition, all covenants,
easements and restrictions of record. If applying as a contractor, I further certify that I am currently
registered in the State of Washington.
Signature Date
Firm
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
2_0(s & 5
CITY OF YELM 5 t_
SIGN PERMIT APPLICATION FORM --H (j�(:
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Project Address: Parcel #:
Zoning, Current Use: Proposed Use:
Type /Number of Sign(s) (wall, monument, lighted, etc.): �-
Value of each Sign: DA
Dimensions of Sign(s):���
Building Gross Floor Area (sq. ft):_
Building Height: _
Existing Signage
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APPLICANT
ADDRESS
CITY I hI il'
an
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ATE 1,41/ ZIP
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BUILDING OWNER �J l�C— �_'-I/ C-It- l 61:;>
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CITY STATE ZIP TELEPHONE
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BUILDING TENANT I JGT/ / Z -
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SIGN CONTRACTOR _ TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
I hereby gertify that the/Aabove information is correct
accord ce with tF�e ws, rules and regulations of
Applicant's Signature
Owner / Contractor / Owner's Aqent on1
t the construction of the above described sign will be in
of Washington and the City of Yelm.
ate
Agent / Tenant (Please circle one.)
All permits are non - transferable and will expire if work authorized by such permit is not begun
within 180 days of issuance, or if work is suspended or abandoned for a period of 180 days
FEB 04 2015
105 Yelm Ave W
Yelm, WA 98597
q(,& _Srs- q�;-
(360) 458 -3835
(360) 458 -3144 FAX
www.ci.yelm.wa.us
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