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4510 SEAHURST AVE 2016-08-30
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4510 SEAHURST AVE 2016-08-30
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Last modified
1/12/2017 10:28:22 PM
Creation date
8/30/2016 3:49:53 PM
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Template:
Address Document
Street Name
SEAHURST AVE
Street Number
4510
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� [ ¢�' (`� '�f � ' � �t. Y ?.�k [ � �\ � � �� �. i�i i'�,{ 6 �e, � ` "�.m 1 �-�,4 'te`,4 <br />_ � �r- m: <br />, <br />G . �. ; `,z. p � , .'.`w, �.e< � .�__�:< . " . ..` u F p",S. ,....t': <br />�I� 6 �� ��� ��� �� '� �� �'��� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereftwa.org <br />`��� � ��C�'I K(li 2� i /-� =� <br />PROJECT ADDRESS <br />� �G <br />Owner <br />Tenant <br />�, <br />�, <br />Electrical Contractor <br />D �- � <br />Mail Address <br />Mail Address <br />Mail Address <br />S I C��L����L � C � �� <br />State License Number (required) <br />City <br />City <br />City <br />�- �7� / ( t_i Lj � ✓ <br />Sta /Zt ie p � Phone <br />State/Zip Phone <br />r ��Z� <br />,�z �'�z/ :�yg � �'�' <br />State/Zip Phone <br />�J � ��� <br />City of Everett Business License Number (required) <br />%2 � � �,J Od , <br />Proposed Use of B dding Contract Price of Work <br />c�C—�L� �Al�cY�-� �%Z-�S-2'��-��` 7� <br />��C�O J�S ��CLi/�.�CC,EJ���'�'ffvD� G�cvt <br />Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br />Number of devices (If low voltage) <br />Description of Work to Be Done: //L/5/�-�y �/ v2� �'C��-/!� l ���%'�—L�l ��� . . <br />� __ __ � <br />� • � .�l-fv � ��� �an,✓',`�L — _ � <br />_ . - � <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />, � _� _ _ <br />�� ��J(� s <br />I hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any otherstate orlocal law regulating construction or the <br />performance of construction. That 1 am authorized by the owner of this property to perform the <br />work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />�- <br />REVISED 08/O6/20i4 <br />FEE <br />��� � �� <br />PERMIT# <br />�I��� �2�� <br />
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