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SIGP] PERI•1IT nPPLICnTION <br />SI'BIQIT 1iVIDENCE THAT EnUZPAlENT <br />CO:dPLIES iVITtl THE STT�NDeIRDS OP <br />A'7 IiPPROVED TESTING LI�BJRI�TOP.Y. <br />I!:SPECTION Or SZGN RT'nUIRED <br />EFFOP.E ERECTIJN. <br />CALL 259-87A5 FOR INSPECTION. <br />Ap��lication Date <br />�� <br />I:DDRESS �� G C� � _ � <br />, <br />�C� . - Z 7 � <br />Tlie undersigned owner hereby a3rees to hold and save harmless the <br />City of Everett from any and a11 clair�s �or damages that may arise <br />because of ir.stallation of the improvement hereto applied for, and <br />f.urther a9rees to remove same ��pon notice from ihe City and to re- <br />place all. public p�-operty dar�t�.gc d thereby. <br />V�ILUE: �(��] c � _ <br />CIRCUITS: _ � ��� � <br />FP•.E: G� , e� v <br />Siqned , <br />Ccntrac' <br />GLGCTRICAL: <br />TOTnL I'PES : <br />/, C�U <br />Owner <br />�'�� _C��) C'C7 <br />1,icense Nc. L)� CI d� I <br />I, � <br />' , , li L'>: � . 1� ' ��. c . �ii�.'% � �-- �C'.^>>�,•• 1 <br />