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20160270 Permit Pkg 06292016City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Applicant: Name: FASA FAMILY WELLNESS, PLLC Address: 1610 BISHOP RD SW STE 101 TUMWATER WA 98512 Property Information: Site Address: 7f11 TAI- nRAA 921 vn CC Assessor Parcel No.: 45170000100 Contractor Information: Name: FASA FAMILY WELLNESS, PLLC Address: TERRENCE & SARA HESS 1610 BISHOP RD SW STE 101 TUMWATER WA 98512 Contractor License No.: Permit No.: 201 60270 Issue Date: 6/29/2016 (Work must be completed within 180 days) Phone: 360- 400 -3338 Owner: Subdivision: EAGLE PLAZA Expires: Phone: Project Information: Project: OTHER SPECIAL EVENT Description of Work: YELM COMMUNITY HEALTH FAIR. AUGUST 19, 2016 Sq. Ft. per floor: First Heat Type (Electric, Gas, Other): Second Third Garage Basement Fees: Item SE Contractor FASA FAMILY WELLNESS, PLLC 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 tru and correct. I also certify that the proposed structure is in conformity with all applicable City of Yelm re �,Its l ions includin those governing zoning and land subdivision, and in addition, all covenants, easeme an restrictio of record. If applying as a contractor, I further certify that I am currently register d in th State o Washington. Signatur Date �Q Firm E -1k�6� �-r_ ... . �.A (. 0 A Lot: Fees $ 0.00 $ 0.00 OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: JUN /28 /2016 /TUE 11:28 AM FAX No, ou((00 J-1 O P. 001 AUG /04/2015/TUE 12:14 PM FASA Y'ELPI FAX No.360 -400 -3330 P,002/003 City of Yelm. D a Community Development Department RionSPECIAL EVENT I TEMPORAR Y USE APPLICATION \4 Special Event Sign Permit (limited to 14 days, 4 times per calendar year) Temporary Use (property owr+er permission letter required) (see REVERSE for regulations) r NAME OF PROJECT ` n l 1 4e „ ! � l g` APPLICANT /BUSINESS NAME Mailing Address I'i5 Q k A f 1 City, State and Zip cR ,,, s Telephones c✓i- 3 EMAIL City of Yelm Business License Number t C� SITE OWNER Mailing Address City, State and Zip Telephone 3 SITE ADDRESS /LOCATION Qo j 1h SITE PARCEL NUMBER SUMMARY OF REQUEST ol 1'c+ 1�� G ru'cS (EIn START DATE END DATE 1 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 afriirm 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 ofYafm and Other governmentnl agencies to enter Upon and inspect said Propefy as reasonably necessary to process this application. Signed i ROUTING: SPECIAL EVENT Building Section TEMPORARY USE Planning $action Building Section 105 Ye17►aAve4ue West Yalm, Wei 98597 0 Y" -------------------- (060) 4$8-38135 (350) 4G8 -x144 FAX Wmw_eiyelm.wea.us Yil�l■ JUN/28/2016/TUE 11:28 AM FAX No. P,002 ` 01, 4. Rf jfk lit it. I 4: ta Kill; INA. 1i Tl 11,1 pp ` 01, 4. Rf jfk lit it. I 4: ta Kill; INA. 1i Tl 11,1