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PERMIT APPLICATION <br />SUBMIT EVIDENCE THAT ,EQUIPP1r.NT <br />C014PLIES WITH THE STANDARDS Or <br />:. AN, APPROVED TESTING LABORATORY. <br />=;I1SPECTION Or SIGN REQUIRED <br />BEFORE ERECTION. <br />CALL 259-8745 rOR INSPECTION. <br />tl v <br />1 Application Date <br />, <br />ADDRESS 14W•� i rtfe �h.:c✓�+F3 �9/-r <br />a The undersigned owner hereby agrees to hold and save harmless the <br />City -of Everett from any and all claims for dathatges that may arise <br />because "of installation of the improvement hereto applied for,.and <br />further agrees to remove same upon notice from the City and to -re- <br />place all' public property damaged thereby..• <br />v --- VALUE: A5 C�Or.���' <br />Yi I E r r xs Tirv6 CIRCUITS: % <br />ELECTRICAL: `� • �G <br />�NCnJ J S16N I S•r 7(iN ruu�,-,j <br />T, <br />. OTAL rEES: /� • ;. <br />rvn, 1 '%+7Qt,rPj r, I I 'r2Fl, Z'• <br />{7, r <br />If <br />i <br />+} cS '� '• . ' ;`1 ,f „ /�i tom( 4 1�@eu�j� . P2QoEE7�o <br />r , <br />4 "ll <br />Sic iie <br />rOwner <br />74, <br />Contractor; flit Y ' (/Cori s r - : �• <br />License No. _S. E, ci- , <br />