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20170111 Permit Pkg 01122017City of Yelm Community Development Department Building Division Phone: (360) 458 -8407 Fax: (360) 458 -3144 Applicant: Name: LIBERTY TAX SERVICE Address: 715 YELM AVE E, STE 3 YELM WA 98597 Property Information: Site Address: 715 YELM AVE E 3 Assessor Parcel No.: 99002045441 Contractor Information: Name: LIBERTY TAX SERVICE Address: 715 YELM AVE E, STE 3 YELM WA 98597 Contractor License No.: Project Information: Project: OTHER SPECIAL EVENT Description of Work: APRIL 1 THRU 15, 2017 Sq. Ft. per floor: First Second Third Garage Basement Fees: Item SE Permit No.: 20170111 Issue Date: 1/12/2017 (Work must be completed within 180 days) Phone: 400 -1401 Owner: Subdivision: Lot: Phone: Expires: 0 /00 /0000 Heat Type (Electric, Gas, Other): Contractor LIBERTY TAX SERVICE TOTAL FEES: Applicant's Affidavit: I certify that I qave 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 includiag.i lose governing zoning and land subdivision, and in addition, all covenants, easements a d restrictions of reco . If applying as a contractor, I further certify that I am currently registered in a St of Washingt �-7 L ; Signature / te Z' Firm 1 I. k_P A V ,\ I& AL Fees $ 0.00 $ 0.00 OFFICIAL USE ONLY # Sets of Prints: Final Inspection: Date: By: J,,?/170 /// SPECIAL EVENT /TEMPORARY USE ZSpecial Event Sign Permit ❑ Temporary Use Start Date: 4/1/2017 End Date: 4/15/2017 Applicant: LIBERTY TAX SERVICE Owner: MITCH BROWN Address: 715 YELM AVE E STE 3 Address: YELM, WA 98597 Telephone: 360- 400 -1401 Telephone: 42-5- 773 -7124 Email: YELM_WA @LIBERTYTAX .COM Email: Representative: Mailing Address: Telephone: Email: General location of the project: Assessor's Tax Parcel Number: Description of Project: Attach a site plan no larger than 11" X 17" showing the proposed development. Yelm City Hall 105 Yelm Avenue West Yelm, WA 98597 (360) 458 -3244 (360) 458 -4348 FAX www.d.yelm.wa.us S,S:a6ed "TMSb092 :01 :WOJA ST *0 ZZ02- 80 -NHf