20150115 Permit Pkg 12222015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Permit No.: 20150115
Issue Date:
(Work must be completed within 180 days)
Applicant:
Name: JAYNE CAMERON Phone: 702 - 845 -5925
Address: PO BOX 2040
YELM WA 98597
Property Information:
Site Address: 102 ym RA AVE E Owner: STEVE CRAIG
Assessor Parcel No.: 64400600900 Subdivision:
Contractor Information:
Name: JAYNE CAMERON Phone:
Address:
PO BOX 2040
YELM WA 98597
Contractor License No.: Expires: 0 /00 /0000
Project Information:
Project: SIGN
Description of Work: WALL MURAL AND MARQUE SIGN
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
SIGN
Contractor
JAYNE CAMERON
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 regulations including those governing �oning 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 tare State of.,Washington.
Signature , ✓ CG, L / Date /
Lot:
Fees
$ 40.00
$ 40.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
CITY OF YELM
SIGN PERMIT APPLICATION FORM
C4
Project Address: Parcel #-
k,, Parc,
Zoning, Current Use: i —Proposed Use,_ I /
h
Type/Number of Sign(s) (wall, monument, lighted, etc.). 91,
Value of each Sign.
Dimensions of Sign(s): L
Building Gross Floor Area (sq. ft):
Building Height:
Existing St LE- 47)0 tz_ &Z�J?EIV
,gnage �if any) and dimensions
APPLICANT-
least N?,q irst Name
�� ADDRESS 177 EMAIL
CITY STATE Zip 23'DTELEPHONE
BUILDING OWNER
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
BUILDING TENANT
ADDRESS j1) EMAIL
CITY STAIE-L,-)�� TELEPHONE.-
SIGN CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
hereby 9,4ify that the/above information is correct arid tt7at the construction of the above described sign will be in
accordoce with t "s, rules and regulations of the St, e of Washington and the City of Yelm.
7 1 t
Applicant's Signature ate
Owner / Contractor I Owner's Agent ,/'Vbntractor' 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
vi;: D7
PE9 0 4 2015
(360) 458-3835
105 YeirriAve W
Yetm, WA 98597 (360) 158-3144 FAX
www.ci.yelm.wa.us
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