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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