20150268 Permit Pkg 08052015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20150268
Issue Date: 8/05/2015
(Work must be completed within 180 days)
Applicant:
NESS PLLC Phone: 360- 400 -3338
Name: FASA FAMILY WELL ,
Address: 1610 BISHOP RD SW STE 101
TUMWATER WA 98512
Property Information:
Site Address: 201 TAHOMA BLVD SE
Owner:
Assessor Parcel No.: 45170000100
Subdivision: EAGLE PLAZA
Contractor Information:
Name: FASA FAMILY WELLNESS, PLLC
Phone:
Address: TERRENCE & SARA HESS
1610 BISHOP RD SW STE 101
TUMWATER WA 98512
Contractor License No.:
Expires: 0 /00 /0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: HEALTH AND WELLNESS
FAIR AUGUST 6, 2015
Sq. Ft. per floor: F. t
Heat Type (Electric, Gas, Other):
i rs
Second
Third
Garage
Basement
Fees:
Item Contractor
SE FASA FAMILY WELLNESS, PLLC
TOTAL FEES:
Applicant's Affidavit:
I certify th t I have read and examined the information contained within the application and know the same
to be tru and correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm re ulations including those governing zoning and land subdivision, and in addition, all covenants,
easem nts a hrestrictions of record. If applying as a contractor, I further certify that I am currently
registe d in of Was��hii/n�jgton.
Sinnati re AAA A+4 Iwo i( Date (`� S
• M I MISSn ,
Lot:
Fees
$ 0.00
$ 0.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
AUG /04/2015/TUE 01:31 PM
Foot &
Ankle Sur-i.,
FAX
No,3607534861
AUG /04/2015/TUE 12:14 PM
FASA
YELM
FAX
No.360- 400 -333C
THMA�
YELM vN
City of Yelm
P. 001/001
P. 002/003
61p le)
Community Development Department
SPECIAL EVENT I TEMPORARY USE
APPLICATION
` 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
APPLICANTIBUSINESS NAME (J
Mailing Address I &. °Is LXI Vy 1
City, State and Zip
Telephone EMAIL
City of Yelm Business License Number 11 J`;
SITE OWNER
Mailing Address ant
City, State and Zip tie
Telephone 5& EMAIL5,,
SITE ADDRESS /LOCATION h eonc� M
\k l yn_�
SITE PARCEL NUMBER
SUMMARY OF REQUEST cal en I
jib
s >�
START DATE r END DATE
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 sire 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 inspact
said props as reasonably necessary to process this appiicatlon.
Signed _ Date�� l J
RQtJT�NG' SPECIAL EVENT Building Section
TENiPORAftY USE Planning Sadion Building Section
105 i'elm Aueuue West (26p1 �d8 -�'83a
Yetm, WA 98597 (360) 458 -aI44 FA. c
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