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� � <br /> o � � r� od � p � : <br /> D �� :; <br /> � JUN 1 4 1969 ' <br /> � ': <br /> .._...... .........................._............................... ,, <br /> CITY Of EVERETT / " <br /> PuWic Works Dept. Date: _�D — z -r� L r <br /> To: Ben Edwards, Plans Examiner <br /> Res Owner's Name: o �' �, EK ER <br /> Project Address: ,� <br /> l.ttached are Repair Specificationa for the above mentioned � <br /> pcoject. Please provide CBIP the following information by � <br /> initialing the proper box: � <br /> �� <br /> i <br /> , � '� <br /> YES NO , <br /> : Plan Check Fee Requireds � I <br /> , �� I <br /> Pleeee retucn this form to CHIP as soon possible. \� ; <br /> � ' � <br /> : Tha u. � <br /> ! <br /> � <br /> ; 8I Staff `:� <br /> cc: aau�dsa; Aead Building Inspector <br /> � � <br /> � <br /> � � <br /> i <br /> i <br />