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SIGN CITY OF EVERETT <br /> PERMIT PERMIT SERVICES <br /> EVERETT <br /> 3200 CEDAR STREET EVERETT,WA 98201 <br /> WASHINGTON (425)257-8810 <br /> Online Inspection Request:onlinepermits.everettwo.gov <br /> PERMIT NUMBER: S2212-013 ISSUED DATE: <br /> JOB ADDRESS: 133RD ST SW APN: <br /> OWNER: Test Owner TENANT: BAZAN SERAFIN&JOSEFINA <br /> 123 main <br /> San diego,CA 92101 <br /> PHONE: PHONE: (555)555-5555 <br /> DESCRIPTION OF WORK: CONTR: BAZAN SERAFIN&JOSEFINA <br /> testing expiration notice-do not change status or exp.date <br /> 123 main <br /> test San diego,CA 92101 <br /> PHONE: (555)555-5555 <br /> CONTRACT PRICE OF WORK: $12.00 <br /> PERMITS EXPIRE IF WORK NOT COMMENCED WITHIN 180 DAYS OR CEASES MORE THAN 180 DAYS. <br /> FEES: ACKNOWLEDGEMENT OF CONDITIONS <br /> PLAN CHECK FEE $1.00 By purchasing this permit and commencing work,the owner/applicant <br /> hereby agrees to the above listed permit conditions and agrees to hold <br /> Percent Credit Card Fee $0.02 and save harmless the City of Everett from any and all claims for <br /> Percent Credit Card Fee $0.02 damages,costs,expenses,or causes of action that may arise because of <br /> Percent Credit Card Fee $0.02 the construction hereto applied for and further agrees to remove same <br /> upon notice from the City. <br /> TOTAL FEE $1.06 <br /> TOTAL FEES PAID $0.00 <br /> TOTAL FEE $1.06 <br /> City of Everett Local <br /> REMARKS: Sales Tax Code is 3105. <br /> PERMIT NO. <br /> S2212-013 <br /> —APPLICANT/JOB SITE COPY _TREASURER _ADDRESS FILE _FILE _COUNTER _ASSESSOR <br />