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5904 BROADWAY 2016-01-01 MF Import
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5904 BROADWAY 2016-01-01 MF Import
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Last modified
1/24/2017 9:30:37 AM
Creation date
1/24/2017 9:30:23 AM
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Template:
Address Document
Street Name
BROADWAY
Street Number
5904
Imported From Microfiche
Yes
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i -- �— --- -� -- --� ------- --- ---- -- - — <br /> I <br /> j �I����Ri�,q,�. ��F�Illll`� APF'i���A`�I�t� <br /> � C17Y OF EVERE�T ��RMI�' S�RVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—v✓e,nv.everettwa.org � <br /> � CJS/O -o�� <br /> I � � rm�� Wa� /p —�.,IS <br /> I � , <br /> PROJ CT ADDRESS <br /> 955e, r�2 <br /> I R .v�p� �r o .ac 1 �, 7 5 0� �os cv c I� � sek �-t 1��� I U � � �— <br /> � Owncr —T— � ilAddress (,vAv N � City StatelZip �honc <br /> � <br /> � _ <br /> i — <br /> Tei�aM C� Ma�lAddress Ciry StatelZ�p Phone <br /> � I I<� �I/ll� � � C- 10 6 <br /> � } I1 � o0 k ��o 5 v � �Uu�r . Nut�< � �7eo 5� � -616 — <br /> �C�.i �y-, . 1�7c m ct� <br /> i Eleclnc�l�o h7ailAddress C N .i t �� City � f O q 0 State/Z�p "hone <br /> _f j � 7 <br /> ,\ � � <br /> IState License Number(re ty of Everett Business I_icense Number(required) <br /> ��F-- <br /> � Proposed Use of�ui!ding Contract Price ef Work <br /> I <br /> � Square Footage (li residential new construction, remodel or addition) Contad PersodCentact Number/Cmail <br /> I <br /> � Number of devices QI low vol�age) <br /> Descriptian o1 Work�o f3e�one: �[��G t� � �`��� �a4 �� 1�P�r� �*j � G��_�._ <br /> C��FC � (Z<<�.Jo���l� - -- <br /> I <br /> i — – -- – <br /> I Fre -----– — <br /> I CITY OF EVERETT LOCAL SAL[S TAX CODE IS 3105 �� �� <br /> II hereby certily lhaf 1 bavc re��d nnd examined fhis��pplic�fion ond knnw the same fo be fiue ond ___-� <br /> cerrecf. All pmvisions olla�vs and ordinances goveming(his fype o/wo�k wrll be cnmplefed — <br /> whetherspecificd herein ornot. The yranling ol a pennil does not presume fo give authonly to PERMITtI <br /> violote or cancei Ihe p�nvisions o/any othersfate orlocal/aw n:gulafing consWclion or the r/ <br /> peifoRrrance o/consfruction. That 1 am authorized by fhe o�vnerollhis property�o peiform the E I�� � _ D� y <br /> «ak/or whir.h applicalion is made and I cornp/y with fhe S(afe Confra�(o�s Law 18.27 RGW and � <br /> 296200 WAC. <br /> �r1gtQ1L� �t.JCr-n�-�, ���5�15 <br /> Sign3Nre Da <br /> rr v�s'o aac+�.:n N <br />
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