20150189 Permit Pkg 05082015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20150189
Issue Date: 5108/2015
(Work must be completed within 180 days)
Applicant:
Name JIFFY LUBE Phone: 360- 400 -5823
Address: 1002 YELM AVE EAST
YELM, WA 98597
Property Information:
Site Address: 1002 YELM AVE E Owner:
Assessor Parcel No.: Subdivision:
Contractor Information:
Name: BOB MADDUX Phone: 360- 458 -0510
Address: 2626 395TH ST CT S
Lot:
ROY, WA 98580
Contractor License No.: Expires: 0 /00 /0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: FREE BIKE REPAIR CLINIC - MAY 9 THRU MAY 23, 2015
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
SE JIFFY LUBE $ 0.00
TOTAL FEES: $ 0.00
Appli ant's Affidavit:
I certffy 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 regul ons inc ding those governing zoning and land subdivision, and in addition, all covenants,
ease ents and res ctions of record. If ap lying as a contractor, I further certify that I am currently
re red i the S ate of Was i ton.
Signa ure Date
Firm
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
2[qSaf 9'9
0 H e 46 City of Ye l m
Community Development Department
SPECIAL EVENT I TEMPORARY USE
APPLICATION
L
WASHINGTON
Special Event Sign Permit (limited to 14 days, 4 times per calendar year)
Temporary Use (property owner permission letter required)
(see REVERSE for regulations)
NAME OF PROJECT f P CCL
APPLICANT /BUSINESS NA_ ME
Mailing Address 2 ° S ✓ f S
City, State and Zip
Telephone 36 0 U EMAIL clrlear r)ef 2 fee) . `-e
City of Yelm Business License Number
SITE OWNER t_�A7 — D//
Mailing Address oy Z
City, State and Zip 1Z t'wl
Telephone , C �i� _% 5 � 2 � EMAIL
SITE ADDRESS /LOCATION
SITE PARCEL NUMBER
SUMMARY OF REQUEST
START DATE___Ijla END DATE 3 -)a X
I affirm that all answers, statements and information above and submitted with this application are complete and
accurate to the best of my knowledge. I also affirm that I am the owner of the subject site or am duly authorized by
the owner to act with respect to this application. Further, I grant permission from the owner to any and all
employees and representatives of the City of Yelm and other governmental agencies to enter upon and inspect
said property asyepsoRably n ssary ocess this application.
Signed 7 Date 5 _
ROUTING: SPECIAL EVENT Building Section
TEMPORARY USE Planning Section Building Section
105 Yelm Avenue West
Yelm, WA 98597
MAY 0 7 2015
(360) 458 -3835
(360) 458 -3144 FAX
www.ci.yelm.wa.us
We Yelm Jiffy Lube give Bob Maddux permission to have
a bicycle repair clinic on May 23rd 2015
Yelm Jiffy Lube Store Manager
Thomas Phi ips