20160128 Permit Pkg 02232016City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: SEA MAR COMMUNITY HEALTH
Address: 1040 S HENDERSON ST
SEATTLE WA 98108
Property Information:
Site Address: 202 CULLENS RD NW
Assessor Parcel No.: 21724141200 Subdivision: N/A
Contractor Information:
Name: SEA MAR COMMUNITY HEALTH
Address:
1040 S HENDERSON ST
SEATTLE WA 98108
Contractor License No.:
Permit No.: 20160128
Issue Date: 2/23/2016
(Work must be completed within 180 days)
Phone:
Owner: SEAMAR COMMUNITY
HEALTH
Phone:
Expires: 0 /00 /0000
Project Information:
Project: SIGN
Description of Work: ILLUMINATED MONUMENT SIGN INSTALLATION
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
SIGN
Contractor
SEA MAR COMMUNITY HEALTH
TOTAL FEES:
Applicant' i Affidavit:
I certify tha I have read and examined the information contained within the application and know the same
to be true E id correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regul [tions including those governing zoning and land subdivision, and in addition, all covenants,
easements ana4estrictions of record. If applying as a contractor, I further certify that I am currently
registered i t State of Washi g n.
Signature Date
Firm L I Lei
Lot: N/A
Fees
$ 125.00
$ 125.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
J�Y�642g
CITY OF YELM
SIGN PERMIT APPLICATION FORM
Project Address: y Gti�C� 3 S 4' Al Parcel #: 2 7
Zoning; G S
- "`�� Current Use: AtdAtcftk - Proposed Use:
Type /Number of Sign(s) (wall, monument, lighted, etc.): i t f w" t1%,t` e%* CJ-
Value of each Sign-(7� > ,
Dimensions of Sign(s):
Building Gross Floor Area (sq. ft): l 1:;;-0 0 5 F
Building Height: ( g
c
Existing Signage (if any) and dimensions:
7(X �. s
APPLICANT
Last Namt0 sue; First Name J
ADDRESS )0000 l 6 Arc, NF EMAIL S G Lt^'1ot �.ar� b0. `
1f
CITY STATE t✓4 ZIP rIX004f TELEPHONE 419" -6 -oYi( C4,t8
BUILDING OWNER SP.iI_ a•✓ G�""s''•�^""'6 Y �4(- �'+��✓' S
ADDRESS lO KO S0, 4" t --scK St. EMAIL
CITY SU,t -Fl STATE / TELEPHONE ';L06 - 76 -- ' 71
BUILDING TENANT Sum -1t e - 4n.? 0 —"w
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
SIGN CONTRACTOR c TELEPHONE ;W - M l d U
ADDRESS So. 6 , EMAIL Ke. ti h r w�- 3�'.'ZC
CITY t STATE I✓ ZIP ( O FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
U,J*SA -Ct f A/-1 `V ( SE It y 13' E
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.
pplicant's Sig ture 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
_ 12 J 2016
105 Yelm Ave W a W60) 458 -3835
Yelm, WA 98599 4 (3
www.ci.yelm.wa.us
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Karen Bennett
From: Seth Lundgaard [SethLundgaard @seamarchc.org]
Sent: Tuesday, February 23, 2016 9:37 AM
To: Karen Bennett
Subject: RE: City of Yelm - Sign Permit Fee Sheet, SeaMar Community Health
Good Morning Karen,
Can you please confirm receipt of the check for this fee? Also, could I ask you to mail the permit to the sign contractor,
directly?
Seth Lundgaard
Facilities Manager
BAZAN ARCHITECTS
2000116TH AVENUE NE. SUITE 4
BELLEVUE, WA 98004
www.bazanarchitects.com
Office 425 - 637 -0831 ext. 8
Mobile 253 - 353 -6212
From: Karen Bennett [mailto:KarenB @ci.yelm.wa.us]
Sent: Thursday, February 11, 2016 9:13 AM
To: Seth Lundgaard < SethLundgaard @bazanarchitects.com>
Subject: City of Yelm - Sign Permit Fee Sheet, SeaMar Community Health
Good Morning Seth. Attached you will find the signage fee sheet for SeaMar
Community Health. Yelm City Hall is open Monday thru Friday, 8 am thru 5 pm for
permit pick up. You can also mail in a check and I can send the permit package out to
you. Just let me know. Thanks and have a great Thursday!!
Karen T. Bennett
105 Yelm Ave W
Yelm, WA 98597
(360)458 -3835
karenb P ci. uelm. wa. us
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