20170229 Permit Pkg 06092017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: FIRE WITHIN YOGA
Address: 303 FIRST ST S
YELM WA 98597
Property Information:
Site Address: 201 YELM AVE E
Assessor Parcel No.: 64400800100 Subdivision:
Contractor Information:
Name: FIRE WITHIN YOGA
Address:
303 FIRST ST S
YELM WA 98597
Contractor License No.: Expires
Permit No.: 201 70229
Issue Date: 6/09/2017
(Work must be completed within 180 days)
Phone: 360- 878 -2000
Owner: TYPE CURRENT OWNER
NAME
Phone:
0 /00 /0000
Project Information:
Project: SIGN
Description of Work: SIGN ON EAST SIDE OF BUILIDNG 2.5 FT X 8 FT.
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
SIGN
Contractor
FIRE WITHIN YOGA
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 certify that the proposed structure is in conformity with all applicable City of
Yelm regulations including those governing zoning and land subdivision, and in addition, all covenants,
easements and restrictions of record. If applying as a contractor, I further certify that I am currently
registered in th State of Washington. % q
Signature. Date
Firm
Lot:
Fees
$ 125.00
$ 125.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
Cit of Mm
(36) 458 -3244
RECD: 00271467 6/09/2017 �:45 PM
OPER: AS TERM: 001
REFt :
PAID BY:
ACC1 #: XXXXXXXXXXXXXXXXXXX
AUTH #: 054314
TRAN #: 000000000621
TYPE: PURCHASE
TRAM: 33.0000 BUILDING P[RMI13
20170229 125.O(CR
FIRE WITHIN YOGA
201 YELM AVE E
SIGN 125.O(CR
1ENDERED: 125.00 (REDIT CARD
APPLIED: 125.00-
CHANGE: 0.00
CITY OF YELM
SIGN PERMIT APPLICATION FORM
�� (3)4.0�Q l
Project Address: 2�- A Parcel #: %Ood ct
S� G ..-
Zoning; (77 rtiOrlQ4-� Current Use: ti - "t-JA -b Proposed Use:
Type /Number of Sign(s) (wall, monument, lighted, etc.):-- -5 s io -�--�
Value of each Sign: �= �> 2
Dimensions of Sign(s). �� r� / /v ' � sywa ® 00 % 1l jam ' 'I
20
X Building Gross Floor Area (sq. ft): C., Ci ` S _
Building Height:
f o
Existing Signage (if Pnvl and dimensions: (3) Z`x G - /2X3 =
7%,Z -Y- :- ,emu 7 -rs,
-J b
APPLICANT It,) 'QS- S
Last Name First Name
ADDRESS 5-\- EMAIL
CITY `fi�( vin .STATE ZIP 1,< r 2- - TELEPHONE 3 po Cl)
L.9-7.77- MTHErAwd
IN V1059im
13E .DING TENANT
ADDRESS o S ti EMAIL ` Q.S
STATE NE CITY H �Z��
?, -'�C C)
'c.cL��on��.�` .=� c� -zits
SIGN CONTRACT %i/;' TELEPHONE
ADDRESS EMAIL
_
CITY :.�_ STATE ZIP ,SAX
CO RACTOR'S LICENSE # 0, � S/ XP 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.
icant's Signature Date
er / Contractor / Owner's Agent / tractor's Agent Tenant lease circle one.)
�All perm s#An tt isf #04,4wil'e r ork authorized by such permit is not begun
within 180 days �6f i 4suance, or if work i suspef ed or abandoned for a period of 180 days
approved
MA`s (J ."I 2U17
105 Yelm Ave W
Yelm, WA 98597
( J58 -3835
( 0 '�g3?19+t�sRR /Rf/
www.ci.yelm.wa.us
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