20160219 Permit Pkg 05162016City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: JIFFY LUBE
Address: 1002 YELM AVE E
YELM WA 98597
Property Information:
Site Address: 1(102 YELM AVE E
Assessor Parcel No.:
Contractor Information:
Name: JIFFY LUBE
Address:
1002 YELM AVE E
YELM WA 98597
Contractor License No.:
Permit No.: 20160219
Issue Date: 5/16/2016
(Work must be completed within 180 days)
Phone:
Owner:
Subdivision: Lot:
Phone:
Expires: 0 /00 /0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: MEMORIAL DAY - SIGNAGE MAY 26 THRU JUNE 8, 2016
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
SE
Contractor
JIFFY LUBE
TOTAL FEES:
Applicant's idavit:
I certify that I ave read and examined the information contained within the application and know the same
to be true an correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regulati ns iDe ng th se governing zoning and land subdivision, and in addition, all covenants,
easements a d r stnctions record. If applying as a contractor, I further certify that I am currently
registered in ` �1�q ington.
Signature /� r /� Date
Firm —� ; <1U 'G D
Fees
$ 0.00
$ 0.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
wok Tf—fe P
4
i XSNINGTON
City of Yelm
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
APPLICANT /BUSINESS NAME
Mailing Address
City, State and Zip
Telephone EMAIL��
City of Yelm Business License Number �' I
SITE OWNER
Mailing Address
City, State and Zip
Telephone EMAIL
SITE ADDRESS /LOCATION
SITE PARCEL NUMBER
SUMMARY OF REQUEST p- 6,-Alei
aZ lt:jd In '-r J
START DATE fV11 02 lv 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 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 property as easonably necessary. to process this application.
Signed Date
ROUTING: SPECIAL EVENT Building Section
TEMPORARY U...w..+ +. ......- Tanning Section Building Section
105 Yelm Avenue West r- .•4 ? 1 (360) 458 -3835
Yelm, WA 98597�� �' �Y� (360) 458 -3144 FAX
wwwx i.yelm. wa. us
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