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3900 BROADWAY BASE FILE 2023-04-28
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3900 BROADWAY BASE FILE 2023-04-28
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Last modified
4/28/2023 1:11:53 PM
Creation date
4/10/2023 6:41:28 AM
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Address Document
Street Name
BROADWAY
Street Number
3900
Tenant Name
BASE FILE
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' Tft'''� Washington State Patrol Fire Protection Bureau 11078P <br /> Office of the State Fire Marshal <br /> Pyrotechnic Operator License <br /> ••mow.,aF <br /> Licensee Data <br /> Darik Nelson Phone Number: (000) 000-0000 <br /> 1422 85th Drive Northeast Email Address: dariknelson@gmaii.com <br /> Lake Stevens, WA 98258 Date of issue: February 28, 2023 <br /> License Number: P-04495 Date of Expiration: January 31, 2024 <br /> State Fire Marshal Licensee Signature <br /> 3=420-aa 110,+8, General Display Employer Portion <br />
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