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1 1J � <br />everett THE EVERGREEN <br />CITY OF <br />everett DATE�e — 2 7 <br />CITY HALL • EVERETT ctrY OF EVERETT <br />WASHINGTON 98201 <br />INSPECTION REPORT <br />Inspecting Department: <br />License Electrical _,_ Weights & Meas. <br />Fire Housing Engineering <br />Building Plumbina <br />Inspectors Signature <br />Premises Inspected: <br />Type of Building or property <br />Location or Address 4 S/"d 6 —/ q <br />Items Insnected: /A""" j2"/- <br />Items appearing to need additional inspection: <br />in attendance on the Premises, <br />certify that the above inspection was made. <br />Si;anature <br />Form No. 424--001 X <br />R <br />t <br />