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• • SIGI� P�RMIT APPLICATInN /��� � � <br /> SUB[4IT EVIDENC� TIIAT EnUIPP1�NT /���- 7G • <br /> C0:9PLI�S WITH THli STANDARDS OP <br /> AtJ APPROV�D T�STING LAgOR1�TORY. �d/2G/�C <br /> INSPECTION OP SIGN REQUIRED <br /> BEFOf2E �RECTION. • <br /> CALL 259-8745 I'OR INSP�CTION. <br /> Application' Date Oct 18, 197b <br /> �D1tEss 8907 Evergreen ',�Jy <br /> The undersigned o�aner hereL-y agrees to hold and save harmless the <br /> • City oi �verett £rom any and all claims for damages that may arise <br /> because of installation of the improvement hereto applied for, and <br /> :`.urther agrees to remove same upon notice fr.om the City and to re- <br /> place all public property damaged thereby. , <br /> . i VALU�: ,54000, 00 I � - �� <br /> ���, , <br /> CIRCUITS: 2 7, , <br /> .. FEE: <br /> �� ' . ELECTRICAL: <br /> / \\ — <br /> / TOT�L FEES: � � �,� <br /> �, �� <br /> -� / <br /> � � ��. „ t. <br /> , ='�1z1=_. I �I <br /> �_ . <br /> � , <br /> ; � � <br /> � � / �'/ � � -- <br /> j �'��� r"�t, 3, . � <br /> . `�/ � <br /> � ., _. <br /> ! I , <br /> �h <br /> x� . <br /> / <br /> / \ <br /> % <br /> ��� (o-2�°'�i` � <br /> a,< - �.�� �a��o��� <br /> �,�� , �� o <br /> �,r o�-F���,- �����;� .�� <br /> Signed Ken ' s Camera X / <br /> /b-r�`1L � < Owner <br /> Contractor Simco Si n Co inc . <br /> License No. _�272P3 (Electrical D1334) <br />