20150280 Permit Pkg 08252015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20150280
Issue Date: 8/25/2015
(Work must be completed within 180 days)
Applicant:
Name: OIL EXPRESS SITE 281270 Phone
Address: 11308 DAVENPORT ST
OMAHA NE 68154
Property Information:
Site Address: 1002 YELM AVE E Owner:
Assessor Parcel No.: Subdivision:
Contractor Information:
Name: OIL EXPRESS SITE 281270 Phone:
Address: DBA JIFFY LUBE
11308 DAVENPORT ST
OMAHA NE 68154
Contractor License No.: Expires: 0 /00 /0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: FREE BIKE CLINIC AUGUST 30 THRU SEPTEBER 12, 2015
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
SE
Contractor
OIL EXPRESS SITE 281270
/ TOTAL FEES:
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 regula ons including those g rning zoning and land subdivision, and in addition, all covenants,
eagsements n stric ons o) If a lying as contractor, I further certify that I am currently
re istered i the Sta of
Date 17-1 L7'
Firm
866 - 322 -4547
Lot:
Fees
$ 0.00
$ 0.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
P by TNF Je
a
L
WASHINGTON
ile')o-ZeD
City of Yelm
Community Development Department
SPECIAL EVENT/ 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
APPLICANT /BUSINESS NAME
Mailing Address 262-6 � �� .r. S
City, State and Zip c S
Telephone 6 5'' '� EMAIL v r learki /'?�e
City of Yelm Business License Number
SITE OWNER �, - Oi !✓X
Mailing Address
City, State and Zip
Telephone EMAIL
SITE ADDRESS /LOCATION 2. v
SITE PARCEL NUMBER
SUMMARY OF REQUEST
START DATE END DATE / :Z
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 propertVrea na bly gCessary to o ess this application. r/ /
Signed 66G Date
AUG 2 4 ZU15
ROUTING.- SPECIAL EVENT Building Section
TEMPORARY USE Planning Section Building Section
105 Yelm Avenue West (360) 458 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ei.yelm.wa.us
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