20170176 Permit Pkg 04272017City 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: 1f1f17 YFI M AVF F
Assessor Parcel No.:
Contractor Information:
Name: JIFFY LUBE
Address:
1002 YELM AVE E
YELM WA 98597
Contractor License No.:
Permit No.: 20170176
Issue Date: 4/27/2017
(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: FREE BIKE REPAIR CLINIC MAY 6 THRU 20, 2017
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
SE
Contractor
JIFFY LUBE
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 d correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regu 'ions incl ng those governing zoning and land subdivision, and in addition, all covenants,
easement an r striction of record. If applying as a contractor, I further certify that I am currently
registered n t State. of ashingto .
Signature Date
Firm Cdr l�n
Fees
$ 0.00
$ 0.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
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LM
WASHINGTON
,t70 AP
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 1w
Mailing Address Z6-X- 3 5
City, State and Zip Ko Gf_/
Telephone 5'60 ' _U EMAIL a) OC Zc -1r . n
City of Yelm Business License Number
SITE OWNER ;%;
Mailing Address t
City, State and Zip Al -
Telephone EMAIL
SITE ADDRESS /LOCATION ley—?
SITE PARCEL NUMBER
SUMMARY OF REQUEST
START DATE Q G , 16 % END DATE 201
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 a ona x necessa rocess this application.
Signed /%� Date 1
rc
ROUTING: SPECIAL EVENT
TEMPORARY USE
Building Section
Planning Section Building Se;
105 Yelm Avenue West (360) 458 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.yelm.wa.us
April 25, 2017
Bob Maddux, representing the Bike Repair Ministry of McKenna Community Church, has
permission to conduct a free bike repair clinic here at Yelm Jiffy Lube 1002 Yelm Ave E. on Saturday
May 20, 2017. Promotion for the event will begin two weeks prior. Inclusive dates of the event are
May 6 through May 20.
Applicant:
OIL EXPRESS SITE 281270
DBA JIFFY LUBE
11308 DAVENPORT ST
OMAHA NE 68154