20150146 Permit Pkg 03202015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: KAI FYRST
Address: PO BOX 986
YELM WA 98597
Property Information:
Site Address: 701 PRAIRIE PARK LN SE
Assessor Parcel No.: 64303700100 Subdivision:
Contractor Information:
Name: FIRST FINISHERS
Address:
305 WASHINGTON AVEE SW
YELM WA 98597
Contractor License No.: FIRSTFL943BF
Project Information:
Project: SIGN
Description of Work:
Permit No.: 20150146
Issue Date: 3/20/2015
(Work must be completed within 180 days)
Phone: 360- 239 -3742
Owner: KAI FYRST
Lot:
Phone:
Expires:
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
SIGN
Contractor
FIRST FINISHERS
TOTAL FEES:
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 ,?j --�S
Firm
Fees
$ 100.00
$ 100.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Yelm
(36 ) 458 -3244
REC #: 00190320 3/20/2015 12:40 PM
OPER: CO TERM: 001
REF #: 1263
PAID BY:
TRAN: 33.0000 BUILDING PERMITS
20150146 100.000R
FYRST, KAI
701 PRAIRIE PARK LN SE
SIGN 100.000R
TENDERED, 100.00 CHECK
APPLIED: 100.00-
CHANGE: 0.00
215 o Htp
CITY OF YELM
SIGN PERMIT APPLICATION FORM
Project Address: 7() 1 C[6-� r,�Q PG `1<, Lno e SE-0 R Parcel #: 6 4 331'001 GCS
Zoning; C,ry,rnecc+C\� Current Use: i 1 Proposed Use:
Type /Number of Sign(s) (wall, monument, lighted, etc.):
Value of each Sign 0� ,
Dimensions of Sign(s):
Building Gross Floor Area (sq. ft):
Building Height:
i ,i
Existing Signage (if any) and dimensions' tVAc- SJ6A -1 OA.1 <;A2<1&
APPLICANT f `f R'S i KCA �
Last Name First Name
ADDRESS its, c EMAIL
CITY \ :f STATE ZIP 1'�TELEPHONE \J
BUILDING OWNER ( i.tl2[S LUC
ADDRESS loI Prn,1n�;(L L.ctn EMAIL
CITY `fel✓►n STATE L %,� ZIP C C TELEPHONE
BUILDING TENANT `, w. St t \ b g i I'pw{ om
ADDRESS EMAIL Flnesl�owrr�c�.�SCc���on�
CITY Y� 1�, STATE LA ZIP ������1 TELEPHONE -3Lc� -4oc') -
SIGN CONTRACTOR —!4,: i- !LS&L�I.Prc, TELEPHONE 2, - - l Lei
ADDRESS EMAILTi`{E 0 doh l 6�1011-fG . .
CITY STATE ZIP �=1 FAX
CONTRACTOR'S LICENSE #. O EXP DATE CITY LICENSE # /69r/
X4'',6''
I hereby certify that the above information is correct and that the construction of the above described sign will be in
accordance with the laws, rules and regulations of the State of Washington and the City of Yelm.
S--
Applicant's Signature Date
Owner / Contractor / Owner's Agent / Contractor's 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
105 Yelm Ave W
Yelm, WA 98597
� ` rV
D
MAR 17 2015
(360) 458 -3835 --
(360) 458 -3144 FAX
www.ci.yelm.wa.us
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