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, ;IGN PF:Rt•fIT APPLICATION <br />SUUMIT EI�ID)iNCE THAT 6'(tUIP�fENT <br />CO,iPL2ES 4;ITII TNE STANDnRDS OF <br />AN AYPP.O\�ED TLSTIIiG LABOILI'iORY <br />INSPECTION OF SICN REQUIRED <br />BEPORE ERECTION. <br />CALL 259-8745 FOR INSPECTION. <br />APPLIGITION DATE G �( � <br />ADDRESS 72 ��% �_ (�L'�,t' vi��"LS'.,1 c:Jlt' f/ <br />LOS flr <br />The undersigned owner.hereby agrees to tiold and save harmless the <br />City of Everetl• from any and all claims for damages that mny aris� <br />becausc of installntion of thc improvement liereto applied for, and <br />furthcr agrees Lo remove same upon notice from [he City to nnd to re- <br />place all public p�operty damaged thereby. <br />____-�---- �' � y <br />---=-�---� <br />. `� �----.=�`�'y <br />--� �__ _ _` ~_---` <br />� �'_ <br />l ��,i <br />� <br />� <br />N <br />VALUE: 2 S'2 a o� ���L >�S�y:%~ <br />� <br />CIRCUITS: O/VE� ' <br />' V1' L�.i.�i) S/r,�i1;� s..•,�; <br />FEE: _ / � ` = � <br />$L�CTRICAL: ' S`'� <br />TOTAL FCCS: <br />--�_,�. , � <br />� Lz�C/i X � L/-"d'i� <br />'i�fICK.C'/c'�t i /�oc 7 J- a <br />� / I LOO�" BF=Ati7s wiTN <br />1,_.___ _._-_ V�- <br />�%i"'�3 ` " t.N G f. <br />_'` G_2,q ��_- /` <br />�a <br />�1 z •�.��i___ cP � � <br />_Y ° � ' <br />� � S " �__— \ � i1' /�'� � <br />� � y� �� <br />I � a'x��' s,eN � ��� <br />_ „ <br />�V1'�t.GKErN c✓rlc. — - <br />. SIGNED r � r— <br />R <br />corrrttncroP /3f.C'�f'/�l�ONGO. �/cz 7- �/?f--,L.}, �i�iv�v_ <br />LIt;CNSE R0. / — �"O <br />r <br />\ <br />�'. <br />