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everett THE EVERGREEN 4 � u � <br /> CITY OF <br /> everett DATE�=L4 -�� <br /> cirv ruu • EVk1Ert CITYOF EVERETT <br /> W115MINGiON 782UI <br /> INSPECTION NEPORT <br /> Inspecting Department: <br /> Licensc EI2c[rical . Weights& Meas. __ <br /> Fire Housing �_ Engineering __ <br /> Buil�din9 9 /� mbin9 ..� /�^ �— <br /> Ins ctors Si nature y��!—� {:L� _ _ <br /> Premises Inspected: � � ��..��J <br /> Type of 8uilding or property <br /> Location or Address 34� 'f <br /> Items Inspected: � � � � � <br /> [�� <br /> Items appe/�ed additional inspertion: ^ � — <br /> ���� ��* - �� t- <br /> � � � <br /> � �-_ - <br /> �. , in attendance on the Premises, <br /> certify that the above inspection was made. <br /> Signature <br /> t . '" �� , _ .�. <br />