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u <br />SIGN PIiRidIT IIPPLICATZON <br />SUB?4IT LV'.Dl;;CIi TIiAT.EpUIPMEl�7' <br />CG!QPLIES t4IT11 T13L STl?NDnRDS OP' <br />A?7 APPROVED Ti:STIP7G LAIIORATORY. <br />I;iSP�CTI0P,1 Or SIGI� RE(�UIRED <br />EEFOI2E GRLCTIOIJ. . <br />GeLL 259-$7Q5 FOR INS]?LCTION. <br />ADDRESS ,=-2 �> <br />j�� ,'�% <br />. ?�- � <br />/s<a. <br />L: �''-' < <br />i <br />nl�Plication Date � �/ <br />�r. 7/ ,'�C' � <br />The undersianed owner hereby agrees to hold and save harmless thc <br />City of Everett from at,y and all claiMs for damages Lhat may arise <br />because of installation of the improvement hereto applied for,.and <br />further agrees t:o remove same upon not-ice from ihe City and to re- <br />plzc� all public prorcrL-y dar�aged thereby.. <br />V7�LUE: �1����c_S -` :�� <br />CIRCUITS: � <br />. r�L: � <br />�__ <br />ELPCTRICAL: � , �> c-• <br />TOTAL, PLES: � �'��� <br />C����' ���"� <br />EXerlw`Y <br />flK� <br />S�c} w <br />�' <br />'i <br />v <br />� d <br />\ ✓ I <br />� rd-�,� � ,�j� <br />�; _ <br />\ <br />sig»ea _/.�� /Lf-i.� �. � <br />..` � <br />��', Contractor ' ` r <br />'� . ���"— <br />l', License No. _� ` <br />; _. <br />� <br />�_��L�- 4.'��.� � r� iy(-��. <br />O�oncr <br />�I <br />