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10429 19TH AVE SE 2016-10-17
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10429 19TH AVE SE 2016-10-17
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Last modified
1/13/2017 3:13:24 AM
Creation date
10/17/2016 10:25:43 AM
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Template:
Address Document
Street Name
19TH AVE SE
Street Number
10429
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� ,. , „ �. � .. �i� ';� P � �, �, �t ' �,i� p � �" a F�x 4i � "i � �:'�, � e <br />t- . � � � � � ' ` 1 . _P � � y�`` �1 <br />CITY OF EVEREiT PERfVIII" SERVIC <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />f0 y�� 1��� AG�r S� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />�rr��� r 'i <br />� � � <br />City <br />C ity <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />I,v �i�ii y EG�'cr �ic ��l �3�c"�vc S� �f/,���a>��L 9�05'�' 2oE7��y�iz�i <br />EleCtrlCal ContraCtor Mail Address City State/Zip Phone <br />l�/�i//�'S 9�/Z,� � <br />State License Number (required) <br />� ��D �� � <br />Proposed Use�f �uil ing <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />��j���� <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: ��' ���/ ���' � 1�G i/i/� ��Fc !� 7 L r S �r M i� `L(,� /�`3'S <br />��nu� �e'T�c <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 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 governing 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 other state or local law regulating construction or the <br />performance of construction. Thaf I am authorized by the owner of this property to perform the <br />work for which applicatior� is made and I comply with the State Contractors Law 98.27 RCW and <br />296.200 WAC. l <br />��// -���/ %� <br />natu <br />REVISE� 08/O6/2014 <br />FEE <br />�� � <br />PERMIT# <br />E c�0�'�21 � <br />
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