20170293 Permit Pkg 08162017City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: SMASH DELI
Address: 905 SPRING LN
CENTRALIA WA 98531
Property Information:
Site Address: 7n-,A Ym M AVF W
Assessor Parcel No.: 85800300100
Contractor Information:
Subdivision:
Permit No.: 20170293
Issue Date: 8/16/2017
(Work must be completed within 180 days)
Phone: 360- 359 -5103
Owner:
Name: SMASH DELI Phone:
Address:
905 SPRING LN
CENTRALIA WA 98531
Contractor License No.: Expires: 0 /00 /0000
Project Information:
Project: OTHER SPECIAL EVENT
Description of Work: END OF THE SUMMER SMASH AUGUST 26, 2017
Sq. Ft. per floor: First Heat Type (Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item
SE
Contractor
SMASH DELI
TOTAL FEES:
Applicant's Affidavit:
I certify that have read and examined the information contained within the application and know the same
to be true a d correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regula ion incl those governing zoning and land subdivision, and in addition, all covenants.,
easements n r trictions f record. If applying as a contractor, I further certify that I am currently
registered ir th a of ashingto .
Signature M, Date I IQ I
Firm
Lot:
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
/ 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 7 O sz-"-
APPLICANT /BUSINESS NAME
Mailing Address 965-- 'oOA-rl (
City, State and Zip
Telephone EMAIL Siyl�c tl ems "j�l�c� S N�
City of Yelm Business License Number
SITE OWNER -m lji /Z, ---A
Mailing Address L'2-7 i-)
City, State and Zip 7
Telephone EMAIL
SITE ADDRESS /LOCATION JD3
SITE PARCEL NUMBER
SUMMARY OF REQUEST .- - -�
START DATE ( 2-L, 722 1 1 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 act with respect to this application. Further, I grant permission from the owner to any and all
employe nd representative f th City of Yelm and other governmental agencies to enter upon and inspect
said pro y as reas nably e a to process this application.
Signed Date
17
R.
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ROUTING: SPECIAL EVENT Building Section
TEMPORARY USE Planning Section Building Section
105 Yelm Avenue West
Yelm, WA 98597
(360) 458 -3835
(360) 458 -3144 FAX
www.ei.yelm.wa.us