20160287 Permit Pkg 07192016City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: CLAUDIA SHEPARD
Address: 10328 CLARK RD SE
YELM WA 98597
Property Information:
Site Address: 404 FIRST ST S
Permit No.: 20160287
Issue Date: 7/19/2016
(Work must be completed within 180 days)
Phone: 360 - 259 -7777
Owner: TYPE CURRENT OWNER
NAME
Assessor Parcel No.: 22719332300 Subdivision: N/A
Contractor Information:
Name: CLAUDIA SHEPARD Phone:
Address:
10328 CLARK RD SE
YELM WA 98597
Contractor License No.: Expires: 0 /00 /0000
Project Information:
Project: SIGN
Description of Work: REPLACE EXISTING WALL SIGN
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
SIGN
Contractor
CLAUDIA SHEPARD
TOTAL FEES:
Applicant's Affidavit:
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 v rning zoning and land subdivision, and in addition, all covenants,
easements and restrictions of ord. f applying as a contractor, I further certify that I am currently
registered in the State of W hi ton. /
Signature Date C
Firm J
Lot: N/A
Fees
$ 125.00
$ 125.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cite of Mi
(36 0 458 -3244
RECA': 00238234 7/19/2016 12:45 PM
OPER: CO TERM: 001
REFA':
PAID BY:
TRAN: 33.0000 BUILDING PERMITS
20160287 125.0(CR
SHEPARD, CLAUDIA
404 FIRST ST S
SIGN 125.0(CR
TENDERED: 125.00 CASH
APPLIED: 125.00-
CHANGE: 0.00
CITY OF YELM D C M � V �I
SIGN PERMIT APPLICATION FORM JUL 0 6 2016
Project Address: ft �L '— Parcel ��� BY: --------------- - - - --
/S �� �/i'�J� r! )`"
Zoning; Current Use: LIZ Proposed Use:
/ r
Type /Number of Sign(s) (wall, monument, lighted, etc.): ! G
Value of each Sign: '' //
Dimensions of Sign(s): `7� �"Lpl''e' �k ���•hsP
Building Gross Floor Area (sq. ft):
Building Height:
_ /� � �j /rIC�"cil
Existing Signage (if any) and dimensions: V idac <2 I,5( Sc
APPLICANT ,( e : 6,
Last Nam Fi t Name
ADDRESS 1 e lG EMAIL eL "11I1 rsIJYS Ql�rCo
CITY STATE ZIP TELEPHONE
BUILDING OWNER 8a
ADDRESS V EMAIL
CITY STATE ZIP TELEPHONE
BUILDING TENANT
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
SIGN CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #
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.
Applicant's Sig r 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
105 Yelm Ave W (360) 458 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.yelm.wa.us
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