20160185 Permit Pkg 07122016F THE.6, '
City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
YELM
Fax: (360) 458 -3144
Applicant:
Name: HOME TOWN PROPERTY
Address: 1600 4TH AVE E
OLYMPIA WA 98506
Property Information:
Site Address: 204 YELM AVE E
Assessor Parcel No.: 64400701500 Subdivision:
Contractor Information:
Name: SIGNARAMA
Address: JEFF KLINGBERG
2633 WILLAMETTE DR. NE SUITE H
LACEY WA 98516
Contractor License No.: 11052
Project Information:
Project: SIGN
Description of Work:
Sq. Ft. per floor:
Fees:
Item
SIGN
WALL SIGN
First
Second
Third
Garage
Basement
Contractor
SIGNARAMA
Permit No.: 20160185
Issue Date: 7112/2016
(Work must be completed within 180 days)
Phone: 360- 456 -7368
Owner: TYPE CURRENT OWNER
NAME
Phone:
Expires: 12/31/2015
Heat Type (Electric, Gas, Other):
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 certi at the proposed structure is in conformity with all applicable City of
Yelm regulations including those go erning z ng/ and land subdivision, and in addition, all covenants,
easements and restr ions of rec d. If a in s a contractor, I further certify that I a currently
registered in the S to of Washi t /
Signature Date ZZ
Firm
Lot:
Fees
$ 125.00
$ 125.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Yelm
(36 1) 458 -3244
RECD': 00237081 7/12/2016 10 :17 AM
OPER: CO TERM: 001
REFS`: 2563
PAID BY:
TRAM: 33.0000 BUILDING PERMIT'S
20160185 125.0(CR
HOME TOWN PROPERTY
204 YELM AVE E
SIGN 125.0(CR
TENDERED: 125.00 (HECK
APPLIED: 125.00-
CHANGE: 0.00
CITY OF YELM
SIGN PERMIT APPLICATION FORM
Project Address: 0W q \� �( !7- Parcel #: V U��✓�-� �C/
Zoning; Current Use: Proposed Use:
Type /Number of Sign(s) (wall, monument, lighted, etc.): 3
Value of each Sign: / 7d
Dimensions of Sign(s): 36
Building Gross Floor Area (sq. ft): �/&
Building Height:
Existing Signage (if any) and dimensions: (T
APPLICANT 96 ^e– f7^/ /C
Last Na a V Fi t Name
ADDRESS EMAIL
CITY 93 STATE_ y+– ZIP S TELEPHONE
BUILDING OWNER Goff- CtCAW
ADDRESS 3 ( j,14 EMAIL
CITY d vim-.STATE ZIPf Ali;d(> TELEPHONE
BUILDING TENANT
ADDRESS EMAIL
CITY STATE__AC -ZIP TELEPHONE
SIGN CONTRACTOR TELEPHONE
ADDRESSs EMAIL
CITY STATE�i- ZIPFAX
CONTRACTO S LICENSE #&3'tAtJ x><.%EXP DATE ' CITY LICENSE #/
FA
I hereby certify that the above information is correct apd that the construction of the above described sign will be in
accordance with t�lawsr*uteA and regulationsyf -Me State of Washington and the City of Yelm.
Applicant' nature
Own ontractor / Own
All permits are non -tra
within 180 days of isst
105 Yelm Ave W
Yelm, WA 98597
/ Contractor's Agent / Tenant
01816 r•
Date
(Please circle one.)
rmit is not begun
od of 180 days
458 -3144 FAX
ei.yelm.wa. us
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