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everett <br />Inspecting DepartmenC <br />THEEVERGREEN <br />CITY OF <br />everett <br />dTY NAII � EVE�ER <br />W115XINGTON 98701 <br />� e ' <br />• <br />DATE / — I�— ! / <br />CITVOf EVERETT <br />INSPEC710N REPORT <br />License �lectrical m��� Weights & Meas. <br />Fire Hcusing Engineering <br />3uilding lumbing <br />��� <br />InspectorsSignaNre �.�' l�.i��L�� <br />Premiseslnspected: ��� <br />Type of Building or property ( C9 C.� � <br />Location or Address Z�D ,� /`T C av �L �_ / <br />(- �r.s�_{— <br />Items Inspected: � <br />i� <br />�^���, �a �`C1 " l� F�P D � <br />Items appea�ing to need additional inspection: <br />� , in attendance on the Premises, <br />certify that the above inspection was made. <br />Signature <br />Form No. 4�6-00� .� <br />� <br />