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-. <br /> . <br /> SUI3MIT 1?VIUI;NCi; TIIAT Pi'QUIPMLN'I' <br /> COMPLI�S 1VI'I'II 'TIIr STANllAItllS Ol , <br /> TIIZ: UND�RW1tIT�I2S' LAIIORATORY. <br /> ID:SP�CTION OI' SIGN REQUIRED <br /> BEFOR� �R�CTION. <br /> CALL 259-8745 FOR INSPECTION. <br /> Date _/!�(JL��L> �/ / 3 <br /> , <br /> APPLICATION FOR _;5/G/�/ /NSJ'�}L�r}T/p/✓ <br /> Thc undcrsigned owt�er hereby agrees to hold and save liarmlcss the City <br /> of Ev�rett from any and all claims for damages that may arise be�ause of <br /> in�tallation of the improvement' hereto applied for, and further agrees to <br /> remove same vpon notice from the Gity and to replace all puUlic property ' <br /> dama�ed thcreUy. � <br /> VALUE: <br /> �OU`�� , <br /> GII2CUITS: Q�{/G <br /> 1 <br /> � �.1 i�i 1:�- �_'ii-!;i=�1 �j <br /> �1PFF0'vcD rCR E3UILD NG ERI141T <br /> Dotc �/ 'Z/ 7 �QG����� <br /> �' <br /> Signed � CP. _� 2JY Owner <br /> � —f'-yz �� ` �� —yv' Contractor <br /> D ,:r'�..1�/,- � ` �=A��- . <br /> /ull.1-�,E'¢� //-7m-?3 <br /> m�r�9 �C� 2�7�' . <br />