20170244 Permit Pkg 06212017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: THE U WELLNESS CENTER
Address: PO BOX 5100
YELM WA 98597
Property Information:
Site Address: 301 YELM AVE E
Assessor Parcel No.: 99002058843 Subdivision:
Contractor Information:
Name: THE U WELLNESS CENTER
Address:
PO BOX 5100
YELM WA 98597
Contractor License No.:
Permit No.: 20170244
Issue Date: 6/21/2017
(Work must be completed within 180 days)
Phone: 360- 400 -5900
Owner:
Lot:
Phone:
Expires: 0 /00 /0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: GRAND OPENING. FREE STANDING FLAG OUTSIDE OF BLDG.
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
SE
Contractor
THE U WELLNESS CENTER
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 an correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regulat n ose governing zoning and land subdivision, and in addition, all covenants,
easements a d r strictions acord. If applying as a contractor, I further certify that I am currently
registered in a o W ington.
13M--1AA. Signature n , ^ Date
U.
Firm . ( )(i %00k 2X� t /A 14
Fees
$ 0.00
$ 0.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
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City of Yelm
Community Development Department
SPECIAL EVENT I TEMPORARY USE
APPLICATION
L
WAiNINOTgN
;1 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 i tJ 67,r
APPLICANT /BUSINESS NAME
Mailing Address no c� Stom
City, State and Zip � W
Telephone -L� U hoc) EMAIL INFO H-�eu w4i mess oe&A�ej.
City of Yelm Business License Number
SITE OWNER
Mailing Address = -1 L�"l kNJ E
City, State and Zip \1e-1 c J uj 4
Telephone EMAIL
SITE ADDRESS /LOCATION A's is tom=
SITE PARCEL NUMBER `-1 '3
SUMMAR ` OF REQUEST t
START DATE , ` END DATE
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 as reasonably necessary to process this application.
Signed Date ti. C, � / - / 17-
r
11 =1d
A SUN
ROUTING: SPECIAL EVENT Building Section
TEMPORARY USE Planning Section Building SAX4
105 Yelm Avenue West
Yelm, WA 98597
(360) 458 -3835
(360) 458 -3144 FAX
www.ei.yelm.wa.us
Ms
V IC
2617