20040192
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-04-0192-YL
Issue Date 11/22/2004
(Work must be started within 180 days)
Receipt No
34099
Applicant:
Name: 1-5 Signs
Phone.
459-3200
Address 8751 Commerce PI Dr NE
City' Lacey
State WA Zip 98516
Property Information
Site Address 608 Yelm Ave. East
Assessor Parcel No
Subdivision.
Lot:
Contractor Information
Name. 1-5 Signs
Contact:
Phone' 459-3200
Address. 8751 Commerce PL Dr NE
City' Lacey
State: WA Zip'
Contractor License No 15DESM8971JH
Expires 04/16/05106
Business License
Project Informcltion
Project: Venture Bank TI
Description of Work: New entry extended roof and interior wall rem val
Sq Ft. per floor' (1st) 0
(2nd) 0
(3rd) 0
Garage 0
Basement 0
Heat Type (Electric, Gas, Other):
Fees.
Item
Item Fee
Base Amt
Unit Fee
Unit Rate
No Units Unit Desc
Building Permit - Other
Building Plan Review
TOTAL FEES
209.25
136 01
$345.26
000
000
000
000
o 0000
o 0000
00000 $1,000
o 0000
Applicant's Affada"it:
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 futher certify that I am currently
registered in the State of WashingtQll ---.
Signature ~~
OFFICIAL USE ONLY
...
Date
'(-l~i'~
By'
Firm
u ....~ i..1 L I.... L '(:I~' ~
r"E~ CITY OF
'V~l YELM
~ po. Box 479
:; Yelm, WA 98597
:!:-,~"..._ 360-458-8403
RECEIPT No. 34 730
EIVED
..--PORTY FOUR DOLLARS & 20 CENTS
RECEIVED FROM DATE REC. NO.
TECHNICAL TRAINING SOLUTIONS LLC01/20/05 34730
PO BOX 1489
AMOUNT
44 20 CHECK
REF NO.
2325
(I
(1
YEl.}! WA
CJ8597
ACCOUNT NO 2795.0
EXCISE TAX RECEIPT
DIANA
4 'l'H 2004
--._-------------------"------------
},;,~~.~~,~~:i,1ii(~~~.~~t THE"'F,l(C(OF.THIS DOCUMENT HAS ~ REO' BACKGROUND .~ NOT A\WHITE BACI;<G~OU/I:IO~,~~\W.;'i.h.J~~f'k';.l~:;,-. :~'"''
;,~TH'f~ CITY OF
~~I YELM
~ PO. Box 479
Yelm, WA 98597
YE!-.M,>o_ 360-458-8403
-.------------------------------------------------ !
I,
I
I
ir
RECEIPT No. 34731
::CEIVED
****ONE HUNDRED FORTY ONE DOLLARS & 00 CENTS
RECEIVED FROM
1-5 SIGNS IIlC
8751 COMMERCE PLACE DR NW
LACEY. WA 98516
459-3200
DATE REC. NO.
01/20/05 34731
AMOUNT
141 00 CHECK
REF NO.
309251
MISCELLANEOUS RECEIPT
DIANA
VENTURE BANK WEEKEND CALL OUTI G CARLSON
RECEIPT No. 34 732
RECEIVED
~****ONE HUNDRED FIFTY NINE DOLLARS & 70 CENTS
RECEIVED FROM DATE REC. NO
MIDWAY MUFFLER & RADIATOR INC., 01/20/05 34732
4711 PACIFIC HWY E
AMOUNT
159.70 CHECK
REF NO.
50491
FIFE. WA
98424
ACCOUNT NO. 1855 0
EXCISE TAX RECEIPT
DIANA
i
I
i
f
./
4TH 2004
\.S SIGNS. \NC, OISCOUNi iJl,\<.EN Jl,MOUNi pJI,\O
\t-NO\CE. 0"- IE. \N'-'OICE ,,-,,^OLlNi 141 00
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Me SQUARED, INC.
OLYMPIA, WASHINGTON 98506
(360) 754-9339
FAX (360) 352-2044
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S1v09Sv098
.OU1'5U:;)~S S -I
dSv:i:n SO 81 U~r
. .
RECEIPT No 34099
RECEIVED
****THREE HUNDRED FORTY FIVE DOLLARS & 26 CENTS
RECEIVED FROM
DATE
REC NO
AMOUNT
REF NO
65986
I-5 SIGNS
8751 COMMERCE PL DR NE
LACEY. WA 98516
VENTURE BANK Tl
SITE: 608 YELM AVE E
11/22/04 34099 345.26 CHECK
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MISCELLANEOUS RECEIPT
DIANA
BLD PRMT 209.25. PLN REV 136.01
GLAtJLA-,J
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w.~
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address: (pO~ 'iEuvt f\Ve./'JUE, e.. Parcel #. 7' C; tJO / z.&[)c.;tJ 0
Zoning;
Current Use. BAN k'"
Proposed Use .tYtN K
u New Construction .)( Re-Model/ Re-Roof / Tenant Improvement
u Plumbing U Mechanical U Fire Prevent/Suppress/Alarm
Project Description/Scope of Work: ~E:yAGF'"~ E.J<(~TIN(r 6A?'/"'€"
Project Value: _ , Z "
U Other
Building Area (sq. ft) Parking Garage
Building Height ;).0 '
Are there any environmentally sensitive areas located on the parcel?
completed environmental checklist must accompany permit application.
1 st Floor
2nd Floor
3rd Floor_
If yes, a
~wr~~J~:Gl~~~:~~~~~ffjmilij~M~: ''1OJiIA ~P/ BI'r./-J K
ADDRESS 1al c.oLu::.L1E. STR~ EMAIL
CITY LAc..f').4 STATE WA ZIP '11\'"503 TELEPHONE <O;Y-d). 459 3~
~~~~~~~mt!$]~@T~f!;gB wfA
CITY STATE
ZIP
LICENSE #
EMAIL
TELEPHONE
~~r:.t~f@[~t~~.~ill~~f[~~ :C-5 DE;..<;ll:J1-J (:./'o1ANUff\(.'M~EPHONE ,,~.4ff1.3MO
ADDRESS 8151 WMMC:R.c& Pi- DR 1\IE- EMAIL
CITY L.Ac.E.'t STATE wA ZIP Q85lCo FAX 3G:iJ. 46C'o.u4/!'5
CONTRACTOR'S LICENSE # /SnesMlF"'i7/01i EXP DATE.Y.b5.. CITY LICENSE # Ol../-OOi 530.0
R~l!)MaJi>lG~~(!5Nm~Gm0ij N / A
AbDRESS"''"'~''''''''''''>' ,
CITY STATE
CONTRACTOR'S LICENSE #
ZIP
TELEPHONE
EMAIL
FAX
EXP DATE CITY LICENSE #
M~@:oo~tfll.~ei.!4~~@Slill~~ffi~~
ADDRESS
CITY STATE
CONTRACTOR'S LICENSE #
NIIt
,
ZIP
TELEPHONE
EMAIL
FAX
EXP DATE CITY LICENSE #
Copy of City Mitigation documentation (TFC).
I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the
above described property will be in accordance with the laws, rules and regulations of the State of Washington and the
City ofYelm.
~-mo~r;/ Ut6-
Applicant's nature
Owner I Contractor I Owner's Agent I Contractor's Agent I Tenant
11~ /7-04
Date
(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
(360) 458-3835
(360) 458-3144 FAX
www.ci.yelm.wa.us
105 Yelm Avenue West
PO Box 479
Yelm, WA 98597
Received
NOV 1 0 2004
f;
State of Washington
County of Thurston
'. ,.
,
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pa^\a~a8
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
C REGIST. # EXP DATE
CCP1 . I5DESM~971JH 04/16/2005
E~r~CTIY~DPf:-TE, ~ T') ii P 1 / i 6 / 2003
I - 5 DESIGN1 &'~MANuFACTURE
8751 COMMERCE PLACE DR NE
OLYMP# _~~85J.-67.1iZ
Signature - - l V It /~
Issued by DEPARTMENT OF LABOR AND INDUSTRIES
I certify that this is a true and correct copy of a document In the
possession of 1-5 SIgns, Inc DBA. 1-5 Design & Manufacture
(15DESM*971 JH), as of this date
\
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Notary Public in and for the
State of wa~on . ) /J
Residing in rlQ:L tUt
My appointment expires J -ILl -QCS
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