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everett <br />Lei <br />THE EVERGREEN <br />CITY OF <br />everett <br />CITY HAIL • EVERETT <br />WASHINGTON 98201 <br />Inspecting Department: <br />License - Electrical <br />Fire Housing <br />5323 <br />DATE 1 — / d ---- <br />CITY OF EVERETT <br />INSPECTION REPORT <br />Weights & Meas. <br />Engineering <br />Building Plumbing <br />;Z1 <br />Inspectors Signature—_ — <br />Premises Inspected: <br />Type of Building or property <br />Location or Address <br />Items Inspected: <br />Items appearing to need inspection: <br />in attendance on the Premises, <br />ce ify that the above inspection was made. <br />Signature. <br />Form No. 424-001 10 <br />