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20150204 Permit Pkg 05282015City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Applicant: Name: YELM PHYSICAL THERAPY Address: 4740 Avery Lane SE Lacey WA 98503 Property Information: Permit No.: 20150204 Issue Date: 5/28/2015 (Work must be completed within 180 days) Phone: 360- 951 -0754 Site Address: 417 YELM AVE W Owner: YELM PHYSICAL THERAPY Assessor Parcel No.: 75300400100 Subdivision: SOLBERGS FIRST Lot: ADDITION Contractor Information: Name: ESCO PACIFIC SIGN Phone: Address: 627 N.W. MIDDLE ST. CHEHALIS WA 98532 Contractor License No.: 10231 Expires: 12/31/2015 Project Information: Project: SIGN Description of Work: TWO LIGHTED WALL SIGNS Sq. Ft. per floor: First Heat Type (Electric, Gas, Other): Second Third Garage Basement Fees: Item Contractor Fees SIGN ESCO PACIFIC SIGN $ 40.00 TOTAL FEES: $ 40.00 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 corr t. I also certify that the proposed structure is in conformity with all applicable City of Yelm regulations n uding those governing zoning and land subdivision, and in addition, all covenants, easements and est�ictions of rec e�, I furt ar certify that I am currently registered in t St to of Washi to Signature Date Firm Z_ �/4GI' C_ OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: Citr of Yell (36 ) 458 -3244 REC #: 00196404 OPER: CO TERM; 001$12015 REF #: 39750 9:18 AM PAID By; TRAN: 33.0000 20150204 BUILDING PERMITS YELM PHYSICAL 40.00CR SIGN AVE W 417 YELM THERAPY TENDERED 40,OOCR APPLIED: 40.00 CHECK 40.00 - CHANGE: - 0.00 05o ao `P CITY OF YELM SIGN PERMIT APPLICATION FORM Project Address: 'A117 3G 1A" AdCd9U W Parcel #: Zoning; Current Use: Proposed Use: Type /Number of Sign(s) (wall, m ongn t ghted, etc.):Chy. ;e1 Leh «S (.Z) %�I/ //� �i fhfe,, Dimensions of Sign(s): 5 �7` C �� Jr Al rvl.✓ y l j Building Gross Floor Area (sq. ft): Building Height: Existing Signage (if any) and dimensions: A eLd C o�S�rl�c ti 6N A' First Name EMAIL 1 TELEPHOI BUILDING OWNERSen,v S,ye- -- S,lge- T/,PrA i Gircup _Z.uc. ADDRESS,2523 Cedar PAr,f' Loop S� EMAILSe ro -tier r u Cori^ CITY014,m p; A STATE & ZIP 22,& TELEPHONE 3G0- 9S/�a7 '! B.UILDtNG TENANT ADDRESS EMAIL I CITY STATE ZIP TELEPHONE SIGN CONTRACTOR F_sco A,7ci ;c S TELEPHONE 0- 79.7 (o! ADDRESS 627 itt !N%dd t< Sf EMAILS: fas 16 85c4 - Vdc, CITYC &*,q /,.S STATE—hg—ZIP 9,P5 ,?Z_ FAX 3G0 -7`f8- if p CONTRACTOR'S LICENSE -# EXP DATE CITY LICENSE #1013! Z7 25'COPPS873/(U 6-1-2615 I hereby if that the above information is correct and that the construction of the above described sign will be in accord c with the laws, ru{e fe9t4a4Q sof the State of Washington and the City of Yelm. 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 MAY 21 2015 10S Yelm Avenue West 3y: (360) 458 -3835 PO Box 479 sa FAX Yelm, VVA 98597 City of Yelm, CDUw­ci.ye1M.Wa.0 Approved .. /V //S- M F I L"" 1H116 VM WI-), ---V wla/, I -M LLO lauiseauwl^��n1�aY4�NZ 11- 3190L910(09Ea qd k. 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Duane Taylor Esco Pacific Signs Phone: 36o -748 -6461 Fax: 36o - 748 -4299 Duane Pesco pacific.corn