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� <br />� <br />APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />320Q Cedar Street <br />Everett, WA 98201 (425) 257-�810 <br />PUBLIC WORKS PERMIT REQUIRED? <br />Owner: <br />PROV/GEN MEDICAL CENTER <br />Contact: <br />[ContactName] <br />Description of Work: <br />Site Address: <br />Legal Description: <br />Date: 8/19/2014 <br />Bldg Permit #: B1408-032 <br />Mailing Address: <br />POBOX1147 <br />�VERETT, WA, 98206 <br />Gontact E-Mail Address: <br />[ContactEmail] <br />TI-PROVIDENCE <br />900 PACIFIC AVE 5TH FLOOR <br />Comments from Inspector during initial inspection: <br />Approved for Issuance by: <br />�'�i �l� � ����t � <br />Phone: <br />Contact Phone: <br />[ContactPhone] <br />�� � <br />c�� D <br />D� <br />A�� 2 i 2014 ... <br />....pF EVERETt in9 <br />....��CIT �o�ks _ perm <br />public <br />Date: <br />