20150192 Permit Pkg 05192015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: ERICA SMITH
Address: 305 A CREEK ST
YELM WA 98597
Property Information:
Site Address: 305 CREEK ST SE A
Assessor Parcel No.:
Contractor Information:
Name: ERICA SMITH
Address:
305 A CREEK ST
YELM WA 98597
Contractor License No.:
Project Information:
Project: SIGN
Description of Work: WALL SIGN
Sq. Ft. per floor: F t
i rs
Second
Third
Garage
Basement
Fees:
Item
SIGN
Permit No.: 20150192
Issue Date: 5/19/2015
(Work must be completed within 180 days)
Phone: 315- 402 -4592
Owner: ERICA SMITH
Subdivision: Lot:
Phone:
Expires: 0 /00 /0000
Contractor
ERICA SMITH
Heat Type (Electric, Gas, Other):
Fees
$ 20.00
TOTAL FEES: $ 20.00
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 hingto /
Signature Date /
Firm
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Yelm
(36 ) 458 -3244
REC #: 00196034 5/19/2015 3:20 PM
OPER: CO TERM: 001
REF #:
PAID BY:
ACCT #: XXXXXXXXXXXXXXXXXXX
AUTH #: H74113
TRAN #: 000000001725
TRAN: 33.0000 BUILDINGG PERMITS
20150192
SMITH, ERICA
305 CREEK ST SE A
SIGN 20.00CR
TENDERED: 20.00 CREDIT CARD
APPLIED: 20.00-
CHANGE: 0.00
CITY OF YELM 50 I G
SIGN PERMIT APPLICATION FORM — —
Project Address: 3DS A bwk A Parcel #:
Zoning; Current Use: Proposed Use: CAS" Dafp. l',h
Type /Number of Sign(s) (wall, monument, lighted, etc.):�i
_
Value of each Sign: o' 1700 ,
Dimensions of Sign(s):
Building Gross Floor Area (sq. ft): /421W
Building Height:
Existing Signage (if any) and dimensions:
APPLICANT
Last.Name First Name L rc ,/4:z✓
ADDRE S 0SA ('/YAK St. EMAIL
CITY !jClm STATE A} h ZIP �`% TELEPHONE
BUILDING OWNER w &4 1 4e tO 11kiltS
ADDRESS ? . � EMAIL ► .
CITY STATE L ZIP TELEPHONE
_
It
BUILDING TENANT : A
ADDRESS '� C' EMAIL ' / G'( C ,'- r.Lr.ce (r, 7
CITY Lei e 101 STATE f>t.: ZIP % TELEPHO E S - C
SIGN CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
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.
Y��4� t-> if / S
Applicant's Si ature 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
�
FT
! MAY 11 2015
105 Yelm Ave W (360) 458 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.yelm.wa.us