20170289 Permit Pkg 08172017City 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
Contractor Information:
Name: THE U WELLNESS CENTER
Address:
PO BOX 5100
YELM WA 98597
Contractor License No.:
Project Information:
Project: SIGN
Description of Work:
ONE WALL MOUNT
Sq. Ft. per floor:
First
Second
Third
Garage
Basement
Fees:
Item
SIGN
Permit No.: 201 70289
Issue Date: 8/17/2017
(Work must be completed within 180 days)
Phone: 360- 400 -5900
Owner: TYPE CURRENT OWNER
NAME
Subdivision: Lot:
Phone:
Expires: 0 /00 /0000
Heat Type (Electric, Gas, Other):
Contractor
THE U WELLNESS CENTER
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 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 the State of Washington.
Signature - - - -- Date 17
Firm
Fees
$ 125.00
$ 125.00
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
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PAW BY: SHANNON PAULOS
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TRAM #
TYPE: PURCHASE
000000001408
TRAM: 33.0000 BUILDING FYRMI7S
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301 yE[N AVE E —^'^'`
SIGN
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125.00 [REUlr CARD
APPLIED:
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CITY OF YELM
SIGN PERMIT APPLICATION FORM
Project Address: =;01 L VUU4 O C" Parcel #:
V10000M
Zoning; �^vlkfA(- -fZ_CLr.}�._ Current User kXgj- Nk.`SProposed Use: C� �.iI�LCNI S
Type /Number of Sign(s) (wall, monument, lighted, etc.): (�3 C t_ i'-i ac'-A& tom ( NOT LILT- hL�i7�
Value of each Sign:
Dimensions of Sign(s): 0
Q
Building Gross Floor Area (sq. ft): tiJ�
Building Height:
Existing Signage (if any) and dimensions:
TP tt i S
APPLICANT
Last Name First Name
ADDRESS �1 'jcxt -i o" -5vE'Zfl0 EMAIL t1`10 C-J C-_� Hey-- U WkdAeSSc:E'vxk—
CITY N E0iA STATE 1.�A ZIP 4"VSk—1 TELEPHONE M &,Q 4-co 3ciCO
BUILDING OWNER -rCCt s H 'T ' ICA —PSS .
ADDRESS pit=^ EMAIL F S n ww.�.ktl
CITY � ��_ t_1 STATE v` A ZIP qk<� -TELEPHONE � J4�
BUILDING TENANT iJ PV* fp4lvc
ADDRESS I = h EMAIL
CITY STATE r LI,, ZIP TELEPHONE
SIGN CONTRACTOR CCZdA+CSi8i IlAfVA"6 fri ELEPHONE ShO - `5Gt
ADDRESS 7_ EMAIL
CITY STATE Jwr ZIP is Std 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.
App cant's Signatu Date
Owner / Contracto ,/ Ow is Agent / Contractor's Age�/Tenant (Please circle one.)
All permits are non - transferable and will expire if work authorized by such permit is not begun
afir
within 180 days of issuance, or if work is suspended or abandoned for a p
AUG Q 201
8Y:
105 Yelm Ave W (360) 458 -3835
Yelm, WA 98597 (360) 458 -3144 FAX
www.ci.yelm.wa.us
C011 -A