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�I <br /> 1 <br /> , . .. _. <br /> . SIG1� PL'RMIT APPLICATION I y.7 J <br /> SULi9I1 EVIDJ;NCE TIlAT .��pIPAfIiNT a '7 76 � <br /> CU4PLIE5 {9ITH T}iE STni]DARDS OP /� + <br /> RR APPROVfiD T�STING LABORATORY. ' � <br /> 9.x�''"� <br /> I17SPECTIOA] OE' SIGN REQUIRED <br /> IIEF01tE BR�CTI09� � <br /> C7�LL 7.59-67�5 FOR INSPL•'CTION. <br /> Applicatiori Date C�l -��< � � <br /> ADDItESS �j �L � �� �� ' ,�..L�,J�,V. . <br /> The undersigned oti�mer hereby agrees to hold and save harml.css L-hc <br /> • City of Everett from any and a17. clains for damages that may arise <br /> because of installation of the improvement hcreto applied fpr,. and <br /> further agrees to remove same upon notice from the City ar'fS to re- <br /> place all pi�blic property damaged there�!. <br /> � <br /> � VALUE: �r�� �c�" <br /> � <br /> CIRCUITS: � <br /> .. r•��: �� ,c� c� <br /> . ELECTRICAL: 2 . '��' <br /> �• . TOTAL F�ES: I �I . � � � <br /> _ , <br /> � :.. �"'� , <br /> i _ <br /> � <br />, � L— ��'C�-� � _�� <br /> � l e�'�.e�'�! �l� l l�l �� �� ,h c���� <br /> �C c.� G—.�/��� .� � ��—.C� <br /> � < <�C�-��� � ����-��M -� (��.�.��s. <br /> . ��� . � � � � <br /> , , <br /> � , Z . ��P �� , l.�'a�.���-�. 9(►��1-7� . i <br /> . � � c. � � � <br /> S.igned�-�'�,f/ , ` �.¢- Owncr I <br /> Contr.ar.tor / ' • I <br /> � <br /> �= -� 2 •-/�-- f�� fZ�=-- z �{�' �-1� i <br /> Licen�e i�o, �?� � ` <br /> .. . �./lr-?�A��i� �C�v�-r�--. .�'%`� ) i <br />