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0 <br />SIGN PERh1IT T�PPLICATION <br />SUIII4IT EVII�L•'NCE T!fAT .EQOIPPlliNT <br />cotarr,zrs t•azr�3 TIIL s�fnl�DnRDS or <br />A17 APPPOVP•.D TESTIP]G I,ABORA7'ORY. <br />I1�SPECTION OP SIGId RGQUIR13ll <br />ErPORE ERL•'CTION. <br />CALL 259-F37�5 FO1: INSPECTIOIQ. <br />Li�S^_ <br />� <br />ADDRESS ��./� �� <br />�+PPlicatio�Y llai-e ��/z 3/ %!a <br />The undersiqned owner her.eUy agrces to hold and save harmless the <br />City of Everett from any and <:1]. claiMs for rlama:Jes that may ari.se <br />bec�use of :nstallation of i:he improvement hereto applicd for,.and <br />furiher a,rees to remove same upon notice f-r.om the City and to re�- <br />place ali. public property dariaged thereb <br />. VT�LUE: �G7�� <br />CIRCUITS: � <br />FL•'E: <br />ELECTRICnL: <br />To7�r�L rL�s : <br />� -Z c'�o <br />I �U <br />� <br />�5c���n vt�r� 5"7<-1c�tv�u�� r}� ��;5��-c] <br />J�iGt�! A� ��,-c�2 T �/��C-(c= � <br />� �' L CK«-lc�-t <br />� �G�� f�( � � <br />. <br />L��l_ �C�..:SGt�F'c'(`-'CCI` �t�� �'(G�' � �s <br />� I�ovil�DS /� � 'T,�l�f-(L'�� ,�,Y- <br />j2� T� ��� ,C'1�.G�:e��:.� !z'3���, �� � <br />Signed f-1C'-F� L�(�' � G�. `r"' ���/`1r�f..1KC Owncr <br />ConLracLor _����-f$ ___ <br />Liccnsc tva. � �-3`—G��z.—A�'-(-C�_-2r_°--2�ISJr�. <br />