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1 • <br /> . SIGN P�RMIT APPLICATION • <br /> SUBt4IT EVID�NC� TIIAT .EQUIPDf�NT � <br /> COI9PLIES WITH THE STANDARDS Ol.' <br /> AI7 APPROVED TESTING LABORATORY. <br /> ItiSPECTION Or SIGN R�QUIRED <br /> BEFOI2B ERECTION. • <br /> CALL 259-8745 rOR INSPECTTON. <br /> Application' Date � (� f 7G <br /> ADDI2ESS f Z(fl9 f`I �t.t� � T� <br /> The undersigned owner hereby agrees to hold and save harmless the <br /> . City of �verett from any and all claims for damages that may arise <br /> because of installation of the improvement hereto applied for,.and <br /> further agrees to remove same upon notice from the City and to re- <br /> place all public property damaged therebX. ._ <br /> � VALUE: ��dv� <br /> CIRCUITS: ((��ntE� <br /> .. FEE: <br /> '. �LECTRICnL: (`(dK'� <br /> TOTAL F��S: <br /> � � � , . <br /> : <br /> 1 <br /> • Siqned C-'^��/'�i���"C��i%C�-cu�-c:f� <br /> 'r'�'J Owner <br /> Contractor �t� • '' • , <br /> License No. 'Z �� ��L.�tG'—I�rz `�(�C-2�{S v(Z. <br />