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SUISMIT ];VID�NCP�' TI-TAT 1'sQUIPMCN'I' <br />COMl'LI�S WiTI-I T1-IL STANllARDS OL' <br />TI-I� UND�RWRIT�RS' LADORATORY. <br />INSP�CTION Or SIGN R�QUIRED <br />BEFORE ER�CTION. <br />CALi 259-$745 FOR INSPEGTION. <br />APPLICATION <br />Date � y�7y <br />��,�� • -����/ /s / z S'. /i,�'o,�o av �* Y_ <br />The undersigned owner hereUy agrees to hold and save harmless the City <br />of �verett from any and all claims for damages that may arise Uecause of <br />installation of the improvement hereto applied for, and further agrees to <br />remo�re same upon notice from the City and to replace all puUlic property <br />damaged thereby. <br />VALUE: <br />CIRCUITS: <br />�� �/%�-�/�-� G�'����%��J — � <br />✓ <br />�� <br />Signed <br />�ic�r�r ��-yf,y <br />. �.GG�cura.� /- Z �- 7� <br />��,� �' - � �'- ?� <br />7� , � <br />/S o0 <br />owne r <br />cirv or tv�r�c i r <br />F+PPROVED 1'C� C3UILDING P�RMI� <br />Daie _.2_ �i-4� 1;(_ h <br />" -_—_—_ <br />